Change in different classes of chronic back pain suspicious of axial spondyloarthritis: a latent transition analysis of the SPACE cohort

Objectives To follow up four previously identified classes ‘pure axial spondyloarthritis’ (axSpA) (‘axial’), ‘axSpA with peripheral signs’ (‘inflammatory back pain+peripheral’), ‘axSpA at risk’ and ‘no spondyloarthritis’ (‘no SpA’). They reflect the expert-opinion-free construct or ‘Gestalt’ of chro...

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Main Authors: Sofia Ramiro, Robert Landewé, Désirée van der Heijde, Roberta Ramonda, Alexandre Sepriano, Manouk de Hooge, Floris A van Gaalen, Karen Minde Fagerli, Sofia Exarchou, Caroline Bastiaenen, Miranda van Lunteren, Philipp Bosch, Mary-Lucy Marques, Liese de Bruin
Format: Article
Language:English
Published: BMJ Publishing Group 2024-09-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/10/3/e004584.full
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author Sofia Ramiro
Robert Landewé
Désirée van der Heijde
Roberta Ramonda
Alexandre Sepriano
Manouk de Hooge
Floris A van Gaalen
Karen Minde Fagerli
Sofia Exarchou
Caroline Bastiaenen
Miranda van Lunteren
Philipp Bosch
Mary-Lucy Marques
Liese de Bruin
author_facet Sofia Ramiro
Robert Landewé
Désirée van der Heijde
Roberta Ramonda
Alexandre Sepriano
Manouk de Hooge
Floris A van Gaalen
Karen Minde Fagerli
Sofia Exarchou
Caroline Bastiaenen
Miranda van Lunteren
Philipp Bosch
Mary-Lucy Marques
Liese de Bruin
author_sort Sofia Ramiro
collection DOAJ
description Objectives To follow up four previously identified classes ‘pure axial spondyloarthritis’ (axSpA) (‘axial’), ‘axSpA with peripheral signs’ (‘inflammatory back pain+peripheral’), ‘axSpA at risk’ and ‘no spondyloarthritis’ (‘no SpA’). They reflect the expert-opinion-free construct or ‘Gestalt’ of chronic back pain suspicious of axSpA. The aim was to assess participants’ transitions between these classes over time.Methods Participants with chronic back pain of ≤2 years duration, suspicious of axSpA from the SPondyloArthritis Caught Early cohort were analysed. Latent class (LCA) and latent transition analysis (LTA) using clinical, laboratory and imaging data at baseline and 2 years were calculated. Conditional and marginal probabilities were obtained, reflecting the probability of a spondyloarthritis feature in a class and the probability of the participant’s class membership, respectively. Transitional probabilities were extracted revealing potential switches across classes. The analyses were performed in all participants using imputations for missing data and in participants with full data at baseline and 2 years.Results Baseline and 2 years LCA models were constructed for 702 participants, resulting in the same four-class model as previously described. LTA revealed only a 3% transition from the ‘no SpA’ to the ‘at-risk’ class from baseline to 2 years with all other participants remaining in their initially assigned class. Sensitivity analysis on 384 participants with complete data at both baseline and 2 years showed similar results, underlining the model’s robustness.Conclusions Transitions between the four classes over 2 years were basically inexistent, highlighting the unlikelihood of developing new class-defining features of axSpA after an initial clinical workup.
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spelling doaj-art-e2082ad57e7d429cb128b1c8ea98a89a2025-08-20T03:09:55ZengBMJ Publishing GroupRMD Open2056-59332024-09-0110310.1136/rmdopen-2024-004584Change in different classes of chronic back pain suspicious of axial spondyloarthritis: a latent transition analysis of the SPACE cohortSofia Ramiro0Robert Landewé1Désirée van der Heijde2Roberta Ramonda3Alexandre Sepriano4Manouk de Hooge5Floris A van Gaalen6Karen Minde Fagerli7Sofia Exarchou8Caroline Bastiaenen9Miranda van Lunteren10Philipp Bosch11Mary-Lucy Marques12Liese de Bruin13Department of Rheumatology, Zuyderland Medical Centre Heerlen, Heerlen, The NetherlandsAmsterdam Rheumatology Center, Amsterdam University Medical Center, Amsterdam, Netherlands1 Department of Rheumatology, Leiden University Medical Center, Leiden, The NetherlandsRheumatology Unit, Department of Medicine - DIMED, University Hospital of Padova, Padova, ItalyNOVA Medical School, UNL, Lisbon, Portugal9 VIB Center of Inflammation Research, Ghent University, Gent, BelgiumRheumatology, Leiden University Medical Center, Leiden, The NetherlandsCenter for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, NorwayDepartment of Clinical Sciences Malmö, Rheumatology, Lund University, Lund, SwedenDepartment of Epidemiology, Maastricht University, Maastricht, NetherlandsRheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands1 Department of Rheumatology and Immunology, Medical University of Graz, Graz, AustriaDepartment of Rheumatology, Leiden University Medical Center (LUMC), Leiden, NetherlandsDepartment of Rheumatology, Leiden University Medical Center (LUMC), Leiden, NetherlandsObjectives To follow up four previously identified classes ‘pure axial spondyloarthritis’ (axSpA) (‘axial’), ‘axSpA with peripheral signs’ (‘inflammatory back pain+peripheral’), ‘axSpA at risk’ and ‘no spondyloarthritis’ (‘no SpA’). They reflect the expert-opinion-free construct or ‘Gestalt’ of chronic back pain suspicious of axSpA. The aim was to assess participants’ transitions between these classes over time.Methods Participants with chronic back pain of ≤2 years duration, suspicious of axSpA from the SPondyloArthritis Caught Early cohort were analysed. Latent class (LCA) and latent transition analysis (LTA) using clinical, laboratory and imaging data at baseline and 2 years were calculated. Conditional and marginal probabilities were obtained, reflecting the probability of a spondyloarthritis feature in a class and the probability of the participant’s class membership, respectively. Transitional probabilities were extracted revealing potential switches across classes. The analyses were performed in all participants using imputations for missing data and in participants with full data at baseline and 2 years.Results Baseline and 2 years LCA models were constructed for 702 participants, resulting in the same four-class model as previously described. LTA revealed only a 3% transition from the ‘no SpA’ to the ‘at-risk’ class from baseline to 2 years with all other participants remaining in their initially assigned class. Sensitivity analysis on 384 participants with complete data at both baseline and 2 years showed similar results, underlining the model’s robustness.Conclusions Transitions between the four classes over 2 years were basically inexistent, highlighting the unlikelihood of developing new class-defining features of axSpA after an initial clinical workup.https://rmdopen.bmj.com/content/10/3/e004584.full
spellingShingle Sofia Ramiro
Robert Landewé
Désirée van der Heijde
Roberta Ramonda
Alexandre Sepriano
Manouk de Hooge
Floris A van Gaalen
Karen Minde Fagerli
Sofia Exarchou
Caroline Bastiaenen
Miranda van Lunteren
Philipp Bosch
Mary-Lucy Marques
Liese de Bruin
Change in different classes of chronic back pain suspicious of axial spondyloarthritis: a latent transition analysis of the SPACE cohort
RMD Open
title Change in different classes of chronic back pain suspicious of axial spondyloarthritis: a latent transition analysis of the SPACE cohort
title_full Change in different classes of chronic back pain suspicious of axial spondyloarthritis: a latent transition analysis of the SPACE cohort
title_fullStr Change in different classes of chronic back pain suspicious of axial spondyloarthritis: a latent transition analysis of the SPACE cohort
title_full_unstemmed Change in different classes of chronic back pain suspicious of axial spondyloarthritis: a latent transition analysis of the SPACE cohort
title_short Change in different classes of chronic back pain suspicious of axial spondyloarthritis: a latent transition analysis of the SPACE cohort
title_sort change in different classes of chronic back pain suspicious of axial spondyloarthritis a latent transition analysis of the space cohort
url https://rmdopen.bmj.com/content/10/3/e004584.full
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