Predictors of Demyelinating Disease in axSpA

The incidence of demyelinating disease (DD) among patients with spondyloarthritis (SpA) is low, with incident DD higher in axial SpA (axSpA) than in psoriatic arthritis (PsA), according to a recent study published in Rheumatology.

Researchers aimed to investigate the incidence of DD among patients with SpA and identify risk factors predicting DD in this population. Patients with axSpA and PsA were identified from a longitudinal cohort database, with analysis conducted based on the presence or absence of DD. Incidence rates (IRs) of DD were calculated, and competing risk analysis was performed. Cox regression analysis using Fine and Gray’s method was used to evaluate predictors of DD development.

Among 2260 patients with follow-up data, 18 DD events were identified, corresponding to an average IR of 31 per 100,000 persons per year for SpA. The IR of DD at 20 years was higher in axSpA than in PsA (1.30% vs. 0.13%, P = 0.01). The best predictive model for DD development included ever-smoking (hazard ratio [HR] 2.918, 95% CI 1.037–8.214, P = 0.0426), having axSpA (HR 8.790, 95% CI 1.242–62.182, P = 0.0294), and the presence of inflammatory bowel disease (IBD) (HR 5.698, 95% CI 2.083–15.589, P = 0.0007).

A history of TNF-α inhibitor therapy was not found to be a predictor of DD.

Reference

Remalante-Rayco P, Espiritu AI, Daghistani Y, et al. Incidence and predictors of demyelinating disease in spondyloarthritis: data from a longitudinal cohort study. Rheumatology (Oxford). 2024;63(7):1980-1986. doi:10.1093/rheumatology/kead527