{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:47:08Z","timestamp":1791874028137,"version":"4.3.4"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The Assessment of SpondyloArthritis international Society recently defined early axial spondyloarthritis (axSpA) as a duration of two years or less of axial symptoms. Previous studies have shown no significant difference in short\u2010term outcomes between patients with early and established axSpA treated with biologic\/targeted synthetic disease\u2010modifying antirheumatic drugs. To evaluate long\u2010term outcomes, we compared spinal radiographic progression between patients with early and established axSpA who were observed under standard of care treatment in a large Swiss cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with axSpA who had at least two sets of spinal radiographs between 2004 and 2024 in the Swiss Clinical Quality Management registry were scored with the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) by two readers and an adjudicator in case of disagreement. Longitudinal radiographic progression between early and established axSpA was compared (from the time of diagnosis) using a four\u2010parametric logistic model, accounting for the nonlinear progression of mSASSS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 376 patients with 1,181 sets of radiographs, 138 patients had early and 238 had established axSpA. Baseline characteristics were similar between the two groups, with a male predominance (61%) and a high prevalence of HLA\u2010B27 positivity (69%). Mean (SD) overall follow\u2010up was 11.5 (8.6) years. Patients with early axSpA exhibited a lower long\u2010term mSASSS (\u22123.85 mSASSS units, 95% confidence interval [CI] \u22127.28 to \u22120.42) compared with established axSpA. This difference became evident 10 to 15 years after diagnosis. The results remained statistically significant after adjustment for baseline radiographic damage (\u22125.70 mSASSS units, 95% CI \u22129.31 to \u22122.09).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early diagnosis of axSpA is associated with lower long\u2010term spinal structural damage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.70346","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T08:06:32Z","timestamp":1789718792000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Diagnosis of Axial Spondyloarthritis Is Associated With Less Long\u2010Term Spinal Structural Damage: A Longitudinal Analysis of the Swiss Clinical Quality Management in Rheumatic Diseases Registry"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5896-2230","authenticated-orcid":false,"given":"Annik","family":"Steimer","sequence":"first","affiliation":[{"name":"Department of Rheumatology Zurich University Hospital, University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Br\u00e4ndli","sequence":"additional","affiliation":[{"name":"Swiss Clinical Quality Management in Rheumatic Diseases Foundation  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Bachmann","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Zurich University Hospital, University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"G\u00f6tschi","sequence":"additional","affiliation":[{"name":"Swiss Clinical Quality Management in Rheumatic Diseases Foundation  Zurich 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