Trends to shorter diagnostic delay in spondyloarthritis patients during the last decades and association with clinical presentation: data from ASAS-COMOSPA study

Trends to shorter diagnostic delay in spondyloarthritis patients during the last decades and association with clinical presentation: data from ASAS-COMOSPA study

Background Diagnostic delay is one of the greatest challenges in spondyloarthritis (SpA). Better disease knowledge and more accessibility to new image technology could have a positive impact on time to diagnosis.Objectives The objectives are (1) to evaluate trends in time to diagnosis in SpA patient...

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Main Authors: Robert Landewé, Désirée van der Heijde, Filip van den Bosch, Maxime Dougados, Anna Molto, Stefan Siebert, Juergen Braun, Yuko Kaneko, Adeline Ruyssen-Witrand, Martin Soubrier, Atsuo Taniguchi, Masato Okada, Alain Cantagrel, Shigeto Kobayashi, Jon Packham, Philippe Goupille, Rene-Marc Flipo, Alain Saraux, Philippe Gaudin, Roberto Caporali, Raj Sengupta, James Cheng-Chung Wei, Tetsuya Tomita, Fernando Pimentel-Santos, Alberto Ortiz, Gaëlle Varkas, Alejandro Martínez, Shigeyoshi Tsuji, Alejandro Alvarellos, José Maldonado-Cocco, Yoshinori Taniguchi, Fadoua Allali, Raquel Almodovar González, Elena Alonso Blanco-Morales, Maria Aparicio Espinar, Pamir Atagunduz, Pauline Bakker, Leila Benbrahim, Bahia Benchekroun, Alberto Berman, Pedro Carvalho, Gustavo Casado, Francisco Colombres, Eugenio del Miguel Mendieta, Vanesa Duarte, Cristina Fernandez Carballido, Manuel Fernandez-Prada, Pilar Font Ugalde, Dolors Grados Cánovas, Jordi Gratacós Masmitjá, Vittorio Grosso, Naomi Ichikawa, Hisashi Inoue, Taku Kawasaki, Manjari Lahiri, Hernán Maldonado-Ficco, Kazuo Matsui, Ramón Mazzuchelli Esteban, Corinne Micelli, Chisun Min, Mitsuhiro Morita, Juan Mulero Mendoza, Gisela Pendón, Dora Pereira, Hanan Rkain, Oscar Rillo, Carlos Rodriguez Lozano, Adrián Salas, Carlos Salinas-Ramos, Amelia Santosa, Caroline Spiegel, Carmen Stolwijk, Kurisu Tada, Naoho Takizawa, Chung Tei Chou, Lay-Keng Teoh, Wen-Chan Tsai, Olga Tsyplenkova, Kiana Vakil-Gilani, Rafael Valle-Oñate, Virginia Villaverde, Ai Yap, Pedro Zarco Montejo, Juan C Barreira, Juan D Diaz-Garcia, Michel De Bandt, Astrid van Tubergen, Rodolfo Pérez-Alamino, T Marhadour, Christian Waimann, Mari CruzFernandez Espartero, Jose Raul NogueraPons, José A PereiradaSilva
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/11/1/e004756.full
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Summary:Background Diagnostic delay is one of the greatest challenges in spondyloarthritis (SpA). Better disease knowledge and more accessibility to new image technology could have a positive impact on time to diagnosis.Objectives The objectives are (1) to evaluate trends in time to diagnosis in SpA patients during the last decades and (2) to determine the association between clinical presentation and diagnostic delay.Methods Cross-sectional, retrospective international study, including 3984 patients with SpA diagnosis.Statistical analysis Delay in diagnosis was calculated and patients were stratified according to decade of disease onset and initial clinical presentation. Multivariate logistic model, using an early diagnosis (≤2 years) as dependent variable was used. P value<0.05 was considered statistically significant. A possible interaction between decade of disease onset and initial clinical presentation was performed.Results The overall median delay from disease onset to SpA diagnosis was 2.9 (p25−75=0.3–9.8) years. Diagnostic delay showed a progressive decrease during the last decades, patients with disease onset after 2010 showed a shorter delay in diagnosis than those with disease onset during 2000–2010 (m 2.00 vs 0.41 years, p<0.01). Age at disease onset (OR 1.02), axial symptom (OR 16.25), peripheral arthritis (OR 6.81), decade at disease onset (OR 3.80) and extra-musculoskeletal manifestation (OR 2.89) were associated with an early diagnosis, while female gender (OR 0.66) was inversely associated.Conclusions The proportion of patients with early SpA diagnosis improve from 15% before 1980 to 88% when first symptoms occurred after 2010. Type and number of initial clinical presentation were independent predictors of time to diagnosis.
ISSN:2056-5933

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