Seventeen-year reassessment of diagnostic transitions, biologic therapy initiation and mortality in spondyloarthritis: results from the REGISPON-3 study
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: To evaluate disease evolution, diagnostic transitions, time to biologic treatment initiation and mortality in patients with spondyloarthritis (SpA) after 17 years from the original Spanish Registry of Spondyloarthritis (REGISPONSER). METHODS: Spondyloarthritis Registry 3 (REGISPON-3) is a two-timepoint longitudinal study with patients fulfilling the European Spondyloarthropathy Study Group criteria participating in the REGISPONSER study and re-evaluated after 17 years. Clinical, laboratory, radiological and treatment data were collected and compared with baseline. Diagnostic changes according to the rheumatologist's judgement and their associated factors were analysed using multivariable logistic regression. Time to initiation of biologic therapy was evaluated using Kaplan-Meier survival analysis. RESULTS: A total of 536 patients from the REGISPONSER study conducted in 2004 were contacted in 2021 for the REGISPON-3 visit. Of these, 411 were physically re-evaluated, while 125 were confirmed deceased. Among the 411 patients, 31.6% experienced a change in diagnosis in the REGISPON-3 visit, mainly from undifferentiated SpA to axial SpA or psoriatic arthritis. In multivariable analysis, dactylitis, younger age and lower Bath Ankylosing Spondylitis Radiology Index scores were associated with diagnostic change. The use of biologic disease-modifying antirheumatic drugs (bDMARDs) increased from 13.1% to 52.1%. However, the median time to first bDMARD from symptom onset was 32 years (95% CI 30 to 35) and 28 years from diagnosis (95% CI 26 to 32). Among the 125 patients who died, the leading causes were infections (21.6%), cardiovascular (CV) events (20.0%) and cancer (19.2%). CONCLUSIONS: This long-term reassessment reveals significant diagnostic changes in SpA and a mortality burden mainly attributed to infections and CV diseases.
Source: RMD Open
Authors: María Ángeles Puche-Larrubia, Lourdes Ladehesa-Pineda, María Carmen Ábalos-Aguilera, Desirée Ruiz-Vílchez, Laura Berbel-Arcobé, Xavier Juanola-Roura, Marta Arévalo-Salaet, Mireia Moreno, Raquel Almodóvar-González, Cristina Pijoan-Moratalla, Beatriz Joven-Ibáñez, Marta Valero-Expósito, Verónica García-García, Manuel Moreno-Ramos, Enrique Ornilla, Raquel Ena María Granados, Diana Maria Margareta Moldovan, Carlos M Collantes-Sánchez, Alejandro Escudero-Contreras, Eduardo Collantes-Estévez, Clementina López-Medina
Institutions: Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofía, University of Córdoba, Bellvitge University Hospital, Corporació Sanitària Parc Taulí, Universidad Rey Juan Carlos, Hospital Universitario Fundación Alcorcón, Hospital Universitario 12 De Octubre, Hospital Universitario Ramón y Cajal, Hospital Universitario Virgen de la Arrixaca, Clinica Universidad de Navarra, Universidad de Navarra, Iuliu Hațieganu University of Medicine and Pharmacy
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,391
OpenAlex ID: W4414845857