Objective. To determine the predictive factors of outcome in patients
with spondyloarthropathy (European Spondyloarthropathy Study Group or
Amor criteria) monitored by a single investigator. Methods. Classifica
tion of longterm outcome on a 3-grade scale. Candidate predictive fact
ors: presence or not of 12 clinical or biological variables during the
first 2 years of the disease, collected by history at the time of the
first visit. Univariate analysis to pick up the factors statistically
correlated with severity and then odds ratio and 95% confidence inter
val (CI) for each variable were calculated. Results. Of the 328 patien
ts with spondyloarthropathy, 151 had a followup of greater than or equ
al to 10 years and minor disease (81), severe (28), or moderate diseas
e (42). Seven variables at entry were correlated with disease severity
(odds ratio; CI 95%); hip arthritis (22.85; 4.43-118); erythrocyte se
dimentation rate >30 mm/h (7; 4.84-9.50); poor efficacy of nonsteroida
l antiinflammatory drugs (8.33; 2.56-27.10); limitation of lumbar spin
e (7; 2-25); sausage-like finger or toe (8.45; 1.48-9); oligoarthritis
(4.25; 1.38-13.10); onset less than or equal to 16 years (3.47; 1.06-
12.75). If none of these factors is present at entry a mild outcome ca
n be predicted (sensitivity: 92.5 ; specificity: 78%). If a hip is inv
olved or if 3 factors are present, a severe outcome is predictable (se
nsitivity: 50%) and a mild disease practically excluded (specificity:
97.5%). Conclusion. Predictive factors of poor or benign longterm outc
ome could be defined very early after onset of spondyloarthropathy in
a set of patients monitored by one observer.