{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T03:36:36Z","timestamp":1774064196795,"version":"3.50.1"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T00:00:00Z","timestamp":1688083200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Seyoung Association (SYH) research grant from Department of Internal Medicine, Gangnam Severance Hospital","award":["2019-GNS-001"],"award-info":[{"award-number":["2019-GNS-001"]}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"crossref","award":["NRF-2021M3A9G1026605"],"award-info":[{"award-number":["NRF-2021M3A9G1026605"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Disease course of non-radiographic axial spondyloarthritis (axSpA) has been extensively studied in non-Asian population; however, there are limited data in Asian population. This study aimed to evaluate the long-term disease course of non-radiographic axSpA in Asian patients and identify factors associated with progression to radiographic axSpA.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>In this retrospective observational cohort study, 56 Korean patients newly diagnosed with non-radiographic axSpA between 2006 and 2015 were included. All patients fulfilled the Assessment of SpondyloArthritis international Society classification criteria for axSpA, and did not fulfil the radiological criterion of the 1984 modified New York criteria. Disease course was assessed by the rate of progression to radiographic axSpA. Factors associated with the risk of progression to radiographic axSpA were assessed using multivariable Cox proportional hazard regression analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The mean age at baseline was 31.4\u00b113.3 years, and 37 (66.1%) patients were men. Over a mean observation period of 8.4\u00b13.7 years, 28 (50.0%) patients progressed to radiographic axSpA. In multivariable Cox proportional hazard regression analysis, the presence of syndesmophytes at diagnosis (adjusted hazard ratio [HR]: 4.50, 95% confidence interval [CI]: 1.54\u201313.15, p = 0.006) and active sacroiliitis on magnetic resonance imaging (MRI) at diagnosis (adjusted HR: 5.88, 95% CI: 2.05\u201316.82, p = 0.001) were significantly associated with a higher risk of progression to radiographic axSpA, whereas longer exposure to tumor necrosis factor inhibitors (TNFis) was significantly associated with a lower risk of progression to radiographic axSpA (adjusted HR: 0.89, 95% CI: 0.80\u20130.98, p = 0.022).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>During long-term follow-up, a substantial proportion of Asian patients with non-radiographic axSpA progressed to radiographic axSpA. The presence of syndesmophytes and active sacroiliitis on MRI at the time of non-radiographic axSpA diagnosis were associated with a higher risk of progression to radiographic axSpA, while longer exposure to TNFis was associated with a lower risk of progression to radiographic axSpA.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0288153","type":"journal-article","created":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T17:28:43Z","timestamp":1688146123000},"page":"e0288153","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Disease course of non-radiographic axial spondyloarthritis: Data from a long-term retrospective observational cohort"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7962-3697","authenticated-orcid":true,"given":"Oh Chan","family":"Kwon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong-Gil","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min-Chan","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,6,30]]},"reference":[{"key":"pone.0288153.ref001","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/S0140-6736(16)31591-4","article-title":"Axial spondyloarthritis.","volume":"390","author":"J Sieper","year":"2017","journal-title":"Lancet"},{"key":"pone.0288153.ref002","doi-asserted-by":"crossref","first-page":"288","DOI":"10.3349\/ymj.2008.49.2.288","article-title":"Bone and cartilage turnover markers, bone mineral density, and radiographic damage in men with ankylosing spondylitis.","volume":"49","author":"MC Park","year":"2008","journal-title":"Yonsei Med 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Ther."},{"key":"pone.0288153.ref006","doi-asserted-by":"crossref","first-page":"e000430","DOI":"10.1136\/rmdopen-2017-000430","article-title":"Effect of certolizumab pegol over 96\u2005weeks of treatment on inflammation of the spine and sacroiliac joints, as measured by MRI, and the association between clinical and MRI outcomes in patients with axial spondyloarthritis.","volume":"3","author":"J Braun","year":"2017","journal-title":"RMD Open."},{"key":"pone.0288153.ref007","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1002\/art.41477","article-title":"Improvement of Signs and Symptoms of Nonradiographic Axial Spondyloarthritis in Patients Treated With Secukinumab: Primary Results of a Randomized, Placebo-Controlled Phase III Study.","volume":"73","author":"A Deodhar","year":"2021","journal-title":"Arthritis Rheumatol."},{"key":"pone.0288153.ref008","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S0140-6736(19)32971-X","article-title":"Ixekizumab for patients with non-radiographic axial spondyloarthritis (COAST-X): a randomised, placebo-controlled trial.","volume":"395","author":"A Deodhar","year":"2020","journal-title":"Lancet"},{"key":"pone.0288153.ref009","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1080\/1744666X.2018.1477591","article-title":"Radiographic progression in non-radiographic axial spondyloarthritis","volume":"14","author":"M Protopopov","year":"2018","journal-title":"Expert Rev Clin Immunol"},{"key":"pone.0288153.ref010","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1136\/ard.2010.145995","article-title":"Rates and predictors of radiographic sacroiliitis progression over 2 years in patients with axial spondyloarthritis","volume":"70","author":"D Poddubnyy","year":"2011","journal-title":"Ann Rheum Dis"},{"key":"pone.0288153.ref011","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1002\/art.39542","article-title":"Progression of Nonradiographic Axial Spondyloarthritis to Ankylosing 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