Clinical Predictors Associated with Severe Radiographic Sacroilitis in Axial Spondyloarthritis

Grace Yoon and colleagues presented a study to determine if there were clinical predictors of severe sacroilitis. They found association with non-Caucasian ethnicity, disease duration, a history of total hip arthroplasty, and more. Smoking tobacco as measured by pack is also a predictor of severe sacroilitis. With other conclusions the authors see a modifiable risk factor in smoking.
I think, we as rheumatologists or patients’ organisations should put even more emphasis on counseling patients to quit smoking and provide links or access to quit smoking programs.


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Clinical Predictors Associated with Severe Radiographic Sacroilitis in Axial Spondyloarthritis.
Grace Yoon1, Thomas J. Learch2, John C. Davis3 and Lianne S. Gensler4.
1UCSF, San Franciscao, CA, 2Cedars-Sinai, Los Angeles, CA, 3Genentech Inc, South San Francisco, CA, 4UCSF, San Francisco, CA
Conclusion: Severe radiographic sacroilitis appears to be associated with predictable characteristics like disease duration and total hip arthroplasty, but also appears to be associated with less reported characteristics such as familial AS and tobacco use. Smoking may be a modifiable risk factor for the development of severe radiographic AS.


And here’s another study on the damage smoking is doing in ankylosing spondylitis.

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Smoking Is Associated with Syndesmophyte Development in Ankylosing Spondylitis.
Dilek Solmaz1, Servet Akar2, Ismail Sari3, Ozgul Soysal1, Vedat Gerdan1, Fatos Onen2 and Nurullah Akkoc2.
1MD, Izmir,
Turkey, 2Professor, Izmir, Turkey, 3Dokuz Eylul University School of Medicine, Izmir, Turkey
Conclusion: Smoking, male sex, age and BASMI scores are independently associated with structural damage in AS. The association between the presence of calcaneal enthesophytes and syndesmophytes, which was present in univariate analysis but which disappeared after multivariate logistic regression analysis, needs to be further explored in future prospective studies.


And there’s still another study on the damage smoking is doing in ankylosing spondylitis.


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Baseline Radiographic Damage, Elevated Acute Phase Reactants and Cigarette Smoking Status Predict Radiographic Progression in the Spine in Early Axial Spondyloarthritis.
Denis Poddubnyy1, Hildrun Haibel2, Joachim Listing3, Elisabeth Märker-Hermann4, Henning Zeidler5, Jürgen Braun6, Joachim Sieper2 and Martin Rudwaleit7.
1Charite´
Medical University, Campus Benjamin Franklin, Berlin, Germany, 2Charite´ – Campus Benjamin Franklin, Berlin, Germany, 3German Rheumatism Research Centre, Berlin, Germany, 4Dr. Horst Schmidt Kliniken, Wiesbaden, Germany, 5Medizinische Hochschule, Hannover, Germany, 6Rheumazentrum Ruhrgebiet, Herne, Germany, 7Ev. Krankenhaus Hagen-Haspe, Hagen, Germany
Conclusion: The presence of radiographic damage in the spine (syndesmophytes), elevated acute phase reactants and cigarette smoking status predict spinal radiographic progression in early axial SpA.