Early Diagnosis Of Axial Spondyloarthritis Save

I'm Anthony Chan, consultant rheumatologist from The United Kingdom and I'm here in EULA twenty twenty four in Vienna reporting for RheumNow. One of the challenges that we have in Excess Bondular Arthritis remains the delay to diagnosis. And there are now many drives globally to reduce the time from symptom onset to diagnosis. And also this gives us an opportunity to study the clinical features of patients who have early disease and this was presented here at EULA twenty twenty four. It was an oral presentation OP0310 which is a study of patients referred with chronic back pain to the clinic and then subsequently diagnosed with X Axial Spa and this came from the space cohort and these patients who were referred with chronic back pain, they look for the features of clinical features of spondyloarthritis, They measured the acute phase markers, HLA B27, the radiograph and also the MRI and they followed them up over a period of time and they were looking for patients who had the diagnosis from the time of symptom onset of less than two years and then they divided them into patients with XBA and non XBA and look for the characteristics that would help predict the diagnosis of XBA in these patients with early symptoms.

In total they had five forty eight patients who were referred with chronic back pain. They asked the clinicians to rate their level of confidence from zero to 10 in terms of how confident they were of the diagnosis. They looked at also the symptom duration and the overall mean age in this group of the all the patients who referred was 31, years and the mean time from symptom onset was thirteen months, about a third of them were male and about forty one percent of them, had HLA B27. From the five forty eight patients that were referred with chronic back pain, two fifteen of them had a diagnosis of Axis Bundle Arthritis of less than two years. The mean time to diagnosis was thirty five months.

And so what they were looking was to see how what were the clinical features in this group and whether these could help predict the diagnosis in this early group. And they found that the clinical features of Xbar clearly were higher in the patients who had the condition but HLA B27 positivity and sacroiliitis both on x rays and also MRI were the strongest features at the start of the symptoms and also this when followed up at two years were the best predictors of current and also, the diagnosis remaining stable, at the two year mark. And this gave the HLA B27 and the sacroiliitis increased the likelihood by four point two and three point five respectively. When they look at other clinical features, peripheral arthritis, uveitis and also psoriasis raised the likelihood by two times in terms of the current and the future diagnosis of Axis bar being stable. Other clinical features included the response to NSAIDs, the male sex and also of a younger age.

On the converse, there were also features that were not strongly predictive of the diagnosis including the first presentation of inflammatory back pain were not a strong determining factor of regards to the current or future diagnosis of Axis Bundle Arthritis. So as we are increasingly trying to drive the time to diagnosis down, it appears that strong objective findings, mainly HLA B27 positivity and also the presence of sacroiliitis both on x rays and MRIs weighted strongly in regards to the diagnosis in this early cohort. These were then followed by some of the other clinical features as highlighted here in this abstract. So we can learn from studies such as this as we try to see patients much earlier in regards to their symptom onset and how we could be using some of these both radiographic features as well as clinical features to help us to make histiocytosis. I'm Anthony Chen reporting here from Vienna at EULA twenty twenty four.