Ladehesa-Pineda María Lourdes, Ruiz-Vilchez Desirée, Barranco Antonio Manuel, Puche-Larrubia María Ángeles, Font-Ugalde Pilar, Granados Raquel Ena María, Gratacós-Mastmijà Jordi, Juanola Xavier, Escudero-Contreras Alejandro, Collantes-Estévez Eduardo, López-Medina Clementina
Rheumatology Department, Reina Sofia University Hospital, 14004 Cordoba, Spain.
Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain.
J Clin Med. 2025 Mar 14;14(6):1977. doi: 10.3390/jcm14061977.
: To evaluate whether the diagnostic delay in patients with radiographic axial spondyloarthritis (r-axSpA) is associated with poorer short-term outcomes after two years of follow-up. : This was an observational, longitudinal, and prospective study including patients with r-axSpA from the national multicentre Spanish REGISPONSER-AS registry. Patients were divided into two groups according to the mean diagnostic delay (<5 years, ≥5 years). Binary logistic regression models adjusted for disease duration were constructed and used to evaluate the association between diagnostic delay and disease outcomes at two years. The retention rate for first-line treatment with anti-TNF across the groups was evaluated using a log-rank test. A total of 565 patents were included. The mean diagnostic delay was 5.6 ± 6.2 years, with 325 patients experiencing a delay of <5 years and 240 patients experiencing a delay of ≥5 years. A diagnostic delay of ≥5 years was associated, after 2 years, with a higher prevalence of inflammatory bowel disease (IBD) (OR 2.01 (95%CI 1.06-3.83)), a lower prevalence of synovitis (OR 0.68 (95%CI 0.47-0.98)) and dactylitis (OR 0.24 (95%CI 0.11-0.55)), and worse disease activity after adjusting by disease duration. However, no impact was observed on quality of life, structural damage, or work disability, probably due to the short follow-up period. Finally, no differences between the groups were found with regard to the retention rate for first-line anti-TNF treatment. : Diagnostic delay is associated with poorer short-term outcomes in terms of structural damage, dactylitis, and disability in patients with r-axSpA.
为评估影像学轴向性脊柱关节炎（r-axSpA）患者的诊断延迟是否与随访两年后的短期预后较差相关。这是一项观察性、纵向、前瞻性研究，纳入了来自西班牙全国多中心REGISPONSER-AS注册研究的r-axSpA患者。根据平均诊断延迟（<5年，≥5年）将患者分为两组。构建了调整疾病持续时间的二元逻辑回归模型，并用于评估诊断延迟与两年时疾病预后之间的关联。使用对数秩检验评估各组一线抗TNF治疗的保留率。共纳入565例患者。平均诊断延迟为5.6±6.2年，其中325例患者诊断延迟<5年，240例患者诊断延迟≥5年。两年后，诊断延迟≥5年与炎症性肠病（IBD）患病率较高（OR 2.01（95%CI 1.06-3.83））、滑膜炎患病率较低（OR 0.68（95%CI 0.47-0.98））和指（趾）炎患病率较低（OR 0.24（95%CI 0.11-0.55））相关，并且在调整疾病持续时间后疾病活动度更差。然而，可能由于随访期较短，未观察到对生活质量、结构损伤或工作残疾的影响。最后，在一线抗TNF治疗的保留率方面，两组之间未发现差异。诊断延迟与r-axSpA患者在结构损伤、指（趾）炎和残疾方面的短期预后较差相关。
