{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T03:37:29Z","timestamp":1774064249105,"version":"3.50.1"},"reference-count":24,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"unspecified","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Assistance Publique-Hopitaux de Paris"},{"name":"Pfizer France, Biogen, AbbVie, UCB, Lilly, Galapagos, Novartis, MSD, Fresenius"},{"name":"Clinical Research Unit"},{"name":"AP-HP, Paris, France"},{"name":"French Society of Rheumatology"},{"name":"Paris Centre"},{"name":"Institut national de la sante et de la recherche medicale"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2024,7,4]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Inception cohorts aim to describe chronic diseases from diagnosis and over years of follow-up. Axial spondyloarthritis (axSpA) diagnosis might be challenging during the first years of the disease. Thus, identifying the features that will be associated with a confirmed diagnosis over time is key.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the frequency and the predisposing factors for a change of an initial diagnosis in an inception axSpA cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>DESIR is an ongoing national multicentre inception axSpA cohort with currently 12.5 years of follow-up. At the entry visit and confirmed at each visit, the diagnosis of axSpA was based on the opinion of the treating rheumatologist. Follow-up was interrupted in case of a change in this initial diagnosis. Multiple imputation was used to estimate the probability of a change in the initial diagnosis of axSpA for each patient lost to follow-up. Factors predisposing to an unchanged diagnosis of axSpA were then assessed using a multivariate logistic regression model on the imputed data sets.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 708 patients included, over 10 years of follow-up, 45 (6.4%) were excluded due to a diagnosis change and 300 (42.4%) patients were lost to follow-up. Based on the imputation of these 300 patients, a change in their initial axSpA diagnosis was estimated in 42 (14.0%). Factors predisposing to an unchanged initial axSpA diagnosis during follow-up were (ORs (95% CIs)): radiographic sacroiliitis: 17.0 (4.1 to 71.0); psoriasis: 5.3 (2.0 to 14.3); CRP\u22656 mg\/L: 2.7 (1.3 to 5.3); good NSAID response: 2.5 (1.5 to 4.2); HLA B27+: 2.0 (1.3 to 3.3); anterior chest wall pain: 2.0 (1.2 to 3.3) and female sex: 1.9 (1.2 to 3.0).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>These data suggest that a change in diagnosis in recent onset axSpA exists, but is not frequent, and is less likely to occur in the presence of objective features at baseline.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2024-004484","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T22:36:29Z","timestamp":1721774189000},"page":"e004484","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Diagnosis challenges in inception cohorts in axial spondyloarthritis: the case of the French national DESIR cohort"],"prefix":"10.1136","volume":"10","clinical-trial-number":[{"clinical-trial-number":"nct01648907","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2246-1986","authenticated-orcid":false,"given":"Anna","family":"Molto","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Assistance Publique - H\u00f4pitaux de Paris, Paris, France"},{"name":"INSERM, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Serrand","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Clinical Epidemiology, Public Health and Innovation in Methodology (BESPIM), CHU N\u00eemes, Univ Montpellier, Nimes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandrine","family":"Alonso","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Clinical Epidemiology, Public Health and Innovation in Methodology (BESPIM), CHU N\u00eemes, Univ Montpellier, Nimes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8252-7815","authenticated-orcid":false,"given":"Francis","family":"Berenbaum","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Pierre & Marie Curie Paris VI, Hopital Saint-Antoine, Paris, France"},{"name":"Sorbonne Universit\u00e9, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1911-0544","authenticated-orcid":false,"given":"Pascal","family":"Claudepierre","sequence":"additional","affiliation":[{"name":"Rheumatology, H\u00f4pital Henri Mondor, Cr\u00e9teil, France"},{"name":"EA EpidermE, Universit\u00e9 Paris Est Cr\u00e9teil, Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4002-1861","authenticated-orcid":false,"given":"Bernard","family":"Combe","sequence":"additional","affiliation":[{"name":"Rheumatology, CHU Montpellier, Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4528-310X","authenticated-orcid":false,"given":"Laure","family":"Gossec","sequence":"additional","affiliation":[{"name":"INSERM, Institut Pierre Louis d'Epid\u00e9miologie et de Sant\u00e9 Publique, INSERM, Sorbonne Universite, Paris, France"},{"name":"APHP, Rheumatology department, Hopital Universitaire Pitie Salpetriere, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adeline","family":"Ruyssen-Witrand","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Paul Sabatier University Toulouse III, Toulouse, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8454-7067","authenticated-orcid":false,"given":"Alain","family":"Saraux","sequence":"additional","affiliation":[{"name":"Rheumatology, CHU Brest, Brest, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4687-5780","authenticated-orcid":false,"given":"Daniel","family":"Wendling","sequence":"additional","affiliation":[{"name":"Rheumatology, CHU J Minjoz, Besancon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry","family":"Lequerre","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Rouen University Hospital, Inserm Unit 905 & Institute for Biomedical Research, University of Rouen, Rouen, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3009-6229","authenticated-orcid":false,"given":"Maxime","family":"Dougados","sequence":"additional","affiliation":[{"name":"Hopital Cochin, Rheumatology, Universit\u00e9 Paris Descartes Facult\u00e9 de M\u00e9decine, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,7,23]]},"reference":[{"key":"2025090313042419000_10.3.e004484.1","unstructured":"Bijlsma JWJ , Hachulla \u00c9 , Silva JAP , et al . 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