PREDICTIVE FACTORS FOR THE LONG-TERM OUTCOME OF SPONDYLOARTHROPATHIES

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.