Trabecular bone loss tied to ASDAS, inflammatory markers in axial spondyloarthritis

Trabecular bone loss is longitudinally associated with Ankylosing Spondylitis Disease Activity Score (ASDAS) and inflammatory markers in patients with axial spondyloarthritis (axSpA), a study has found.

The investigators analysed data from patients enrolled in the Incheon Saint Mary’s axSpA prospective observational cohort and used the trabecular bone score (TBS) to assess trabecular bone loss. Generalized estimating equation (GEE) models were used to examine the relationship between TBS and disease activity measures (ie, ASDAS, Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], erythrocyte sedimentation rate [ESR], and C-reactive protein [CRP]).

Data from 240 patients (mean age, 37±12 years; 80 percent males) over 4 years of follow-up were assessed. Higher disease activity at baseline showed a trend toward lower TBS according to ASDAS-ESR (p=0.003) and ASDAS-CRP (p=0.016).

In univariate GEE analyses, TBS was significantly associated with disease activity measures, except for BASDAI, over time. TBS showed a longitudinal association with age, smoking, and spinal structural damage in univariate analysis.

Multivariate GEE analysis also revealed the longitudinal association of TBS with ASDAS-ESR, ASDAS-CRP, ESR, and CRP after adjustment for confounding factors. Moreover, ASDAS scores and inflammatory markers longitudinally correlated with TBS in patients with ankylosing spondylitis (AS; 79 percent), but not in those with noradiographic (nr) axSpA. BASDAI scores did not show any association with TBS in either the AS or nr-axSpA groups.