{
  "abstract": "Objectives To evaluate disease evolution, diagnostic transitions, time to biologic treatment initiation and mortality in patients with spondyloarthritis (SpA) after 17 years from the original Spanish Registry of Spondyloarthritis (REGISPONSER).Methods Spondyloarthritis Registry 3 (REGISPON-3) is a two-timepoint longitudinal study with patients fulfilling the European Spondyloarthropathy Study Group criteria participating in the REGISPONSER study and re-evaluated after 17 years. Clinical, laboratory, radiological and treatment data were collected and compared with baseline. Diagnostic changes according to the rheumatologist’s judgement and their associated factors were analysed using multivariable logistic regression. Time to initiation of biologic therapy was evaluated using Kaplan-Meier survival analysis.Results A total of 536 patients from the REGISPONSER study conducted in 2004 were contacted in 2021 for the REGISPON-3 visit. Of these, 411 were physically re-evaluated, while 125 were confirmed deceased. Among the 411 patients, 31.6% experienced a change in diagnosis in the REGISPON-3 visit, mainly from undifferentiated SpA to axial SpA or psoriatic arthritis. In multivariable analysis, dactylitis, younger age and lower Bath Ankylosing Spondylitis Radiology Index scores were associated with diagnostic change. The use of biologic disease-modifying antirheumatic drugs (bDMARDs) increased from 13.1% to 52.1%. However, the median time to first bDMARD from symptom onset was 32 years (95% CI 30 to 35) and 28 years from diagnosis (95% CI 26 to 32). Among the 125 patients who died, the leading causes were infections (21.6%), cardiovascular (CV) events (20.0%) and cancer (19.2%).Conclusions This long-term reassessment reveals significant diagnostic changes in SpA and a mortality burden mainly attributed to infections and CV diseases.",
  "authors": [
    {
      "affiliations": [
        "Rheumatology Department, Reina Sofia University Hospital, Cordoba, Spain",
        "Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain",
        "GC05 Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain"
      ],
      "name": "María Ángeles Puche-Larrubia"
    },
    {
      "affiliations": [
        "Rheumatology Department, Reina Sofia University Hospital, Cordoba, Spain",
        "Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain",
        "GC05 Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain"
      ],
      "name": "Lourdes Ladehesa-Pineda"
    },
    {
      "affiliations": [
        "Rheumatology Department, Reina Sofia University Hospital, Cordoba, Spain",
        "GC05 Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain"
      ],
      "name": "María Carmen Ábalos-Aguilera"
    },
    {
      "affiliations": [
        "Rheumatology Department, Reina Sofia University Hospital, Cordoba, Spain",
        "GC05 Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain"
      ],
      "name": "Desirée Ruiz-Vílchez"
    },
    {
      "affiliations": [
        "Rheumatology Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, Spain"
      ],
      "name": "Laura Berbel-Arcobé"
    },
    {
      "affiliations": [
        "Rheumatology Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, Spain"
      ],
      "name": "Xavier Juanola-Roura"
    },
    {
      "affiliations": [
        "Rheumatology Department, University Hospital Parc Taulí, Sabadell, Spain"
      ],
      "name": "Marta Arévalo-Salaet"
    },
    {
      "affiliations": [
        "Rheumatology Department, University Hospital Parc Taulí, Sabadell, Spain"
      ],
      "name": "Mireia Moreno"
    },
    {
      "affiliations": [
        "Rheumatology Department, Fundacion Alcorcon University Hospital, Alcorcon, Spain",
        "Preventive Medicine and Public Health, Universidad Rey Juan Carlos, Madrid, Spain"
      ],
      "name": "Raquel Almodóvar-González"
    },
    {
      "affiliations": [
        "Rheumatology Department, Fundacion Alcorcon University Hospital, Alcorcon, Spain"
      ],
      "name": "Cristina Pijoan-Moratalla"
    },
    {
      "affiliations": [
        "Rheumatology, 12 de Octubre University Hospital, Madrid, Spain"
      ],
      "name": "Beatriz Joven-Ibáñez"
    },
    {
      "affiliations": [
        "Rheumatology Department, Ramon y Cajal University Hospital, Madrid, Spain"
      ],
      "name": "Marta Valero-Expósito"
    },
    {
      "affiliations": [
        "Rheumatology Department, Ramon y Cajal University Hospital, Madrid, Spain"
      ],
      "name": "Verónica García-García"
    },
    {
      "affiliations": [
        "Rheumatology, Virgen de la Arrixaca University Hospital, El Palmar, Spain"
      ],
      "name": "Manuel Moreno-Ramos"
    },
    {
      "affiliations": [
        "University of Navarra Clinic, Pamplona, Spain"
      ],
      "name": "Enrique Ornilla"
    },
    {
      "affiliations": [
        "Rheumatology Department, Reina Sofia University Hospital, Cordoba, Spain",
        "Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain",
        "GC05 Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain"
      ],
      "name": "Raquel Ena María Granados"
    },
    {
      "affiliations": [
        "Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain",
        "2nd Internal Medicine Department, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania"
      ],
      "name": "Diana Maria Margareta Moldovan"
    },
    {
      "affiliations": [
        "Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain"
      ],
      "name": "Carlos M Collantes-Sánchez"
    },
    {
      "affiliations": [
        "Rheumatology Department, Reina Sofia University Hospital, Cordoba, Spain",
        "Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain",
        "GC05 Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain"
      ],
      "name": "Alejandro Escudero-Contreras"
    },
    {
      "affiliations": [
        "Rheumatology Department, Reina Sofia University Hospital, Cordoba, Spain",
        "Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain",
        "GC05 Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain"
      ],
      "name": "Eduardo Collantes-Estévez"
    },
    {
      "affiliations": [
        "Rheumatology Department, Reina Sofia University Hospital, Cordoba, Spain",
        "Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain",
        "GC05 Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain"
      ],
      "name": "Clementina López-Medina"
    }
  ],
  "title": "Seventeen-year reassessment of diagnostic transitions, biologic therapy initiation and mortality in spondyloarthritis: results from the REGISPON-3 study",
  "uid": "aceea9fa-62d5-5aff-af4a-9e6da5127838"
}