Ten-year clinical outcome of recent-onset axial spondyloarthritis: Results from the DESIR inception Cohort

Objectives: This study aimed to evaluate the 10-year clinical outcome of patients with recent-onset axial spondyloarthritis (axSpA). Methods study design: The DESIR cohort is an inception cohort of axSpA patients. Methods diagnosis and management: The diagnosis and management of patients were based on the decision of the treating rheumatologist. Methods statistical analysis: Both complete cases and imputed data analyses were conducted. Results: Of the 708 enrolled patients, 45 were excluded due to a change in the baseline diagnosis, 3 patients died, and 300 were lost to follow-up over the 10 years. In the completer population, one patient required bilateral total hip replacement, and 56 patients received a pension due to invalidity. The prevalence of main extra-musculoskeletal features increased from baseline to year 10: psoriasis from 18% to 30%, acute anterior uveitis from 10% to 18%, and inflammatory bowel disease from 5% to 10%. The most frequent comorbidity was hypertension, with an increase from 5% to 15% from baseline to year 10. In the imputed data analysis the estimated proportions of patients with an acceptable status at year 10 were 70% [95% CI: 63; 77] for acceptable PASS, 43% [95% CI: 37; 49] for BASDAI < 3, and 48% [95% CI: 41; 56] for ASDAS < 2.1. Conclusion: These findings suggest that despite a quite favorable 10-year outcome exists for severe outcomes, a large proportion of patients present with an important disease burden reflected by patientreported outcomes. This information can be valuable for providing patients with information at the time of diagnosis.