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Joint Bone Spine. 2015 Oct;82(5):345-51. doi: 10.1016/j.jbspin.2015.02.006. Epub 2015 Jul 16.

Clinical presentation of patients suffering from recent onset chronic inflammatory back pain suggestive of spondyloarthritis: The DESIR cohort.

Author information

1
Paris Descartes University, Department of Rheumatology, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Inserm (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, 109, avenue de France, 75013 Paris, France.
2
Inserm (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, 109, avenue de France, 75013 Paris, France.
3
Département d'information médicale, CHU de Nîmes, 30029 Nîmes, France.
4
Department of Rheumatology, Ambroise Paré Hospital, Assistance publique-Hôpitaux de Paris, 92100 Boulogne-Billancourt, France.
5
Department of Rheumatology, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, 75012 Paris, France.
6
Department of Rheumatology, hôpital Henri-Mondor, Assistance publique-Hôpitaux de Paris, 94010 Créteil, France.
7
Department of Rheumatology, CHU de Montpellier, 34295 Montpellier, France.
8
Department of Rheumatology, hôpital de la Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.
9
Department of Radiology, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.
10
Department of Rheumatology, CHU de Tours, 37044 Tours cedex 9, France.
11
Department of Rheumatology, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 75010 Paris, France.
12
Department of Rheumatology, CHU, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France.
13
Paris Descartes University, Department of Rheumatology, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
14
Department of Rheumatology, CHU de Brest, 29609 Brest cedex, France.
15
Department of Rheumatology, Leiden University Medical Center, 2311 Leiden, The Netherlands.
16
Université de Franche-Comté, Department of Rheumatology, CHRU de Besançon, 25030 Besançon, France. Electronic address: dwendling@chu-besancon.fr.

Abstract

OBJECTIVES:

DESIR is a prospective longitudinal multicentric French cohort of patients with inflammatory back pain suggestive of spondyloarthritis, with a 10-year-follow-up. The purpose is to evaluate the performances of the different sets of classification criteria for axial spondyloarthritis, and to describe the frequency and characteristics of the clinical features of axial spondyloarthritis.

METHODS:

Demographic data and items allowing classification and indices calculation were collected, as well as biologic and imaging data. Baseline data are analyzed. The performance of the several classification criteria sets was evaluated (likelihood ratio) with the physician's diagnosis as external gold standard. For the clinical presentation of axial spondyloarthritis, a descriptive analysis was conducted.

RESULTS:

Seven hundred and eight patients are included. Ninety-two percent of them satisfy at least one set of classification criteria: mNY 26%, Amor 79%, ESSG 78%, ASAS 70%; physician's confidence level 6.8±2.7. 81 and 83% of patients fulfil modified (including MRI) Amor or ESSG criteria. Axial involvement is present in 100% of the cases. NSAIDs are taken by 90%, with an NSAID sore of 50±46. BASDAI over 40 is noted in 60% and elevated CRP in 30% of the cases. HLA-B27 is present in 58%. According to ASDAS CRP levels, 12.7% are in inactive disease, 63% in high disease activity; mean BASFI was 30. Peripheral involvement is present in 57%, with arthritis in 37% of these. Enthesitis is noted in 49% of the patients, and first symptom in 22.5%; anterior chest wall involvement is noted in 44.6%, and dactylitis in 13%. For extra articular manifestations, psoriasis is recorded in 16%, uveitis in 8.5% and IBD in 5.1%. Smoking is present in 36.3% and hypertension in 5.1% of the cases.

CONCLUSION:

These data represent the base of evaluation of the follow-up of this cohort, allowing future specific studies.

KEYWORDS:

Classification criteria; Cohort; Epidemiology; Spondyloarthritis

PMID:
26190454
DOI:
10.1016/j.jbspin.2015.02.006
[Indexed for MEDLINE]

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