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Vertebral fracture prevalence, incidence low in axial SpA
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The prevalence and incidence of vertebral fracture is low among patients with early axial spondyloarthritis, according to recent data in the Annals of the Rheumatic Diseases.
“The ankylosed spine is at risk of fractures,” Karine Briot, MD, PhD, of Cochin Hospital, Paris, and colleagues wrote. “The prevalence of [vertebral fractures] in patients with axial SpA is highly variable in different studies, up to 30%. These data are unexpected in a disease affecting a young population, predominantly males and without treatment with glucocorticoids. Actually, the definition of a [vertebral fracture] varies among studies.”
To analyze the incidence of radiographical vertebral fractures during a 5-year period among patients with early axial SpA, Briot and colleagues studied data from the Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR) cohort. According to the researchers, DESIR is a longitudinal, prospective cohort of 708 patients with recent-onset inflammatory back pain, suggestive of early axial SpA, recruited from 25 regional centers in France between October 2007 and April 2010. Participants were assessed every 6 months throughout the first 2 years of the study, then on an annual basis for an expected 10 years.
Briot and colleagues focused on the 432 patients in DESIR who had 5-year X-rays available. All patients’ radiographs had been evaluated at a central facility by a single investigator specialized in the field of vertebral-fracture diagnosis. The researchers analyzed the prevalence and incidence of vertebral fractures and deformities at baseline and over 5 years.
According to the researchers, among the 431 patients included in the study, the diagnosis of vertebral fracture was doubtful and needed adjudication in 4.4% of cases. In all, 3% of patients demonstrated prevalent vertebral fractures located at the thoracic spine, with 12 being grade 1. At 5 years, 1.15% of patients demonstrated incident vertebral fracture, including seven fractured vertebrae, six of which were located at the thoracic spine and of grade 1.
“We found in the DESIR cohort, a population of early SpA, a prevalence of [vertebral fracture] of 3.0% and 1.15% of incidental VFs,” Briot and colleagues wrote. “This confirms our hypothesis that the actual prevalence and incidence of [vertebral fracture] in SpA is lower than that reported in previous studies, probably depending on the characteristics of the population and the methods of vertebral fracture’s assessment avoiding any misclassification of [vertebral deformities].” – by Jason Laday
Disclosure: Briot reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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