Metric Properties of the SPARCC Score of the Sacroiliac Joints - Data from Baseline, 3-month, and 12-month Followup in the SPACE Cohort.
OBJECTIVE
To evaluate metric properties of the SpondyloArthritis Research Consortium of Canada (SPARCC) score of the sacroiliac (SI) joints.


METHODS
Patients with back pain (≥ 3 months, ≤ 2 years, onset < 45 years) were included in the SPACE cohort (SpondyloArthritis Caught Early). Patients with (possible) axial spondyloarthritis had followup visits after 3 and 12 months and were treated according to clinical practice. Magnetic resonance imaging (MRI) of the SI joints (MRI-SI) was scored in 2 independent campaigns (campaign 1: at baseline and 3 months; campaign 2: at baseline, 3 months, and 12 months) by 2 different blinded reader pairs, applying the Assessment of Spondyloarthritis International Society (ASAS) definition (MRI-SI+ vs MRI-SI-; discordant cases were adjudicated by a third reader) and SPARCC score (mean of 2 agreeing readers). Calculations were made for agreement between SPARCC score cutoff values and a consensus judgment of MRI-SI+ (ASAS definition) as external standard, change in SPARCC score, and smallest detectable changes (SDC) over 3 and 12 months.


RESULTS
SPARCC score ≥ 2 showed best agreement with MRI-SI+ in both campaigns. Regarding observed changes in relation to SDC, SPARCC score changed in 70/151 patients; 26/70 patients changed > SDC (3.4), of whom 20 patients received stable treatment over 3 months in campaign 1. Over 3 months, 20/68 patients showed changes in SPARCC score; 11/20 > SDC (2.1), of whom 8 patients received stable treatment. Over 1 year, 23/74 patients changed their SPARCC score; 14/23 changed > SDC (2.4), of whom 7 received stable treatment in campaign 2.


CONCLUSIONS
SPARCC score ≥ 2 can be used as surrogate for a consensus judgment of MRI-SI+ (ASAS definition) in clinical trials. The SDC ranged from 2.1-3.4 dependent on reader pair and were close to the proposed minimum important change of 2.5.
From the Department of Rheumatology, and the Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Rheumatology, University Hospital La Paz, Madrid, Spain; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Amsterdam Rheumatology Center, Amsterdam; Department of Rheumatology, Groene Hart Ziekenhuis (GHZ) hospital, Gouda, the Netherlands; Rheumatology Unit, Department of Medicine, DIMED University of Padua, Padua, Italy.R. van den Berg, PhD; M. de Hooge, MSc; P.A. Bakker, MD; F. van Gaalen, MD, PhD, Department of Rheumatology, Leiden University Medical Center; V. Navarro-Compán, MD, Department of Rheumatology, Leiden University Medical Center, and Department of Rheumatology, University Hospital La Paz; K.M. Fagerli, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; R. Landewé, MD, PhD, Amsterdam Rheumatology Center; M. van Oosterhout, MD, PhD, Department of Rheumatology, GHZ hospital; R. Ramonda, MD, Rheumatology Unit, Department of Medicine, DIMED University of Padua; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center. r.van_den_berg@lumc.nl.
Rosaline
R
van den Berg
From the Department of Rheumatology, and the Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Rheumatology, University Hospital La Paz, Madrid, Spain; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Amsterdam Rheumatology Center, Amsterdam; Department of Rheumatology, Groene Hart Ziekenhuis (GHZ) hospital, Gouda, the Netherlands; Rheumatology Unit, Department of Medicine, DIMED University of Padua, Padua, Italy.R. van den Berg, PhD; M. de Hooge, MSc; P.A. Bakker, MD; F. van Gaalen, MD, PhD, Department of Rheumatology, Leiden University Medical Center; V. Navarro-Compán, MD, Department of Rheumatology, Leiden University Medical Center, and Department of Rheumatology, University Hospital La Paz; K.M. Fagerli, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; R. Landewé, MD, PhD, Amsterdam Rheumatology Center; M. van Oosterhout, MD, PhD, Department of Rheumatology, GHZ hospital; R. Ramonda, MD, Rheumatology Unit, Department of Medicine, DIMED University of Padua; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center.
Manouk
M
de Hooge
From the Department of Rheumatology, and the Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Rheumatology, University Hospital La Paz, Madrid, Spain; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Amsterdam Rheumatology Center, Amsterdam; Department of Rheumatology, Groene Hart Ziekenhuis (GHZ) hospital, Gouda, the Netherlands; Rheumatology Unit, Department of Medicine, DIMED University of Padua, Padua, Italy.R. van den Berg, PhD; M. de Hooge, MSc; P.A. Bakker, MD; F. van Gaalen, MD, PhD, Department of Rheumatology, Leiden University Medical Center; V. Navarro-Compán, MD, Department of Rheumatology, Leiden University Medical Center, and Department of Rheumatology, University Hospital La Paz; K.M. Fagerli, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; R. Landewé, MD, PhD, Amsterdam Rheumatology Center; M. van Oosterhout, MD, PhD, Department of Rheumatology, GHZ hospital; R. Ramonda, MD, Rheumatology Unit, Department of Medicine, DIMED University of Padua; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center.
Pauline A C
PA
Bakker
From the Department of Rheumatology, and the Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Rheumatology, University Hospital La Paz, Madrid, Spain; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Amsterdam Rheumatology Center, Amsterdam; Department of Rheumatology, Groene Hart Ziekenhuis (GHZ) hospital, Gouda, the Netherlands; Rheumatology Unit, Department of Medicine, DIMED University of Padua, Padua, Italy.R. van den Berg, PhD; M. de Hooge, MSc; P.A. Bakker, MD; F. van Gaalen, MD, PhD, Department of Rheumatology, Leiden University Medical Center; V. Navarro-Compán, MD, Department of Rheumatology, Leiden University Medical Center, and Department of Rheumatology, University Hospital La Paz; K.M. Fagerli, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; R. Landewé, MD, PhD, Amsterdam Rheumatology Center; M. van Oosterhout, MD, PhD, Department of Rheumatology, GHZ hospital; R. Ramonda, MD, Rheumatology Unit, Department of Medicine, DIMED University of Padua; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center.
Floris
F
van Gaalen
From the Department of Rheumatology, and the Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Rheumatology, University Hospital La Paz, Madrid, Spain; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Amsterdam Rheumatology Center, Amsterdam; Department of Rheumatology, Groene Hart Ziekenhuis (GHZ) hospital, Gouda, the Netherlands; Rheumatology Unit, Department of Medicine, DIMED University of Padua, Padua, Italy.R. van den Berg, PhD; M. de Hooge, MSc; P.A. Bakker, MD; F. van Gaalen, MD, PhD, Department of Rheumatology, Leiden University Medical Center; V. Navarro-Compán, MD, Department of Rheumatology, Leiden University Medical Center, and Department of Rheumatology, University Hospital La Paz; K.M. Fagerli, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; R. Landewé, MD, PhD, Amsterdam Rheumatology Center; M. van Oosterhout, MD, PhD, Department of Rheumatology, GHZ hospital; R. Ramonda, MD, Rheumatology Unit, Department of Medicine, DIMED University of Padua; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center.
Victoria
V
Navarro-Compán
From the Department of Rheumatology, and the Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Rheumatology, University Hospital La Paz, Madrid, Spain; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Amsterdam Rheumatology Center, Amsterdam; Department of Rheumatology, Groene Hart Ziekenhuis (GHZ) hospital, Gouda, the Netherlands; Rheumatology Unit, Department of Medicine, DIMED University of Padua, Padua, Italy.R. van den Berg, PhD; M. de Hooge, MSc; P.A. Bakker, MD; F. van Gaalen, MD, PhD, Department of Rheumatology, Leiden University Medical Center; V. Navarro-Compán, MD, Department of Rheumatology, Leiden University Medical Center, and Department of Rheumatology, University Hospital La Paz; K.M. Fagerli, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; R. Landewé, MD, PhD, Amsterdam Rheumatology Center; M. van Oosterhout, MD, PhD, Department of Rheumatology, GHZ hospital; R. Ramonda, MD, Rheumatology Unit, Department of Medicine, DIMED University of Padua; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center.
Karen Minde
KM
Fagerli
From the Department of Rheumatology, and the Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Rheumatology, University Hospital La Paz, Madrid, Spain; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Amsterdam Rheumatology Center, Amsterdam; Department of Rheumatology, Groene Hart Ziekenhuis (GHZ) hospital, Gouda, the Netherlands; Rheumatology Unit, Department of Medicine, DIMED University of Padua, Padua, Italy.R. van den Berg, PhD; M. de Hooge, MSc; P.A. Bakker, MD; F. van Gaalen, MD, PhD, Department of Rheumatology, Leiden University Medical Center; V. Navarro-Compán, MD, Department of Rheumatology, Leiden University Medical Center, and Department of Rheumatology, University Hospital La Paz; K.M. Fagerli, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; R. Landewé, MD, PhD, Amsterdam Rheumatology Center; M. van Oosterhout, MD, PhD, Department of Rheumatology, GHZ hospital; R. Ramonda, MD, Rheumatology Unit, Department of Medicine, DIMED University of Padua; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center.
Robert
R
Landewé
From the Department of Rheumatology, and the Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Rheumatology, University Hospital La Paz, Madrid, Spain; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Amsterdam Rheumatology Center, Amsterdam; Department of Rheumatology, Groene Hart Ziekenhuis (GHZ) hospital, Gouda, the Netherlands; Rheumatology Unit, Department of Medicine, DIMED University of Padua, Padua, Italy.R. van den Berg, PhD; M. de Hooge, MSc; P.A. Bakker, MD; F. van Gaalen, MD, PhD, Department of Rheumatology, Leiden University Medical Center; V. Navarro-Compán, MD, Department of Rheumatology, Leiden University Medical Center, and Department of Rheumatology, University Hospital La Paz; K.M. Fagerli, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; R. Landewé, MD, PhD, Amsterdam Rheumatology Center; M. van Oosterhout, MD, PhD, Department of Rheumatology, GHZ hospital; R. Ramonda, MD, Rheumatology Unit, Department of Medicine, DIMED University of Padua; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center.
Maikel
M
van Oosterhout
From the Department of Rheumatology, and the Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Rheumatology, University Hospital La Paz, Madrid, Spain; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Amsterdam Rheumatology Center, Amsterdam; Department of Rheumatology, Groene Hart Ziekenhuis (GHZ) hospital, Gouda, the Netherlands; Rheumatology Unit, Department of Medicine, DIMED University of Padua, Padua, Italy.R. van den Berg, PhD; M. de Hooge, MSc; P.A. Bakker, MD; F. van Gaalen, MD, PhD, Department of Rheumatology, Leiden University Medical Center; V. Navarro-Compán, MD, Department of Rheumatology, Leiden University Medical Center, and Department of Rheumatology, University Hospital La Paz; K.M. Fagerli, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; R. Landewé, MD, PhD, Amsterdam Rheumatology Center; M. van Oosterhout, MD, PhD, Department of Rheumatology, GHZ hospital; R. Ramonda, MD, Rheumatology Unit, Department of Medicine, DIMED University of Padua; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center.
Roberta
R
Ramonda
From the Department of Rheumatology, and the Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Rheumatology, University Hospital La Paz, Madrid, Spain; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Amsterdam Rheumatology Center, Amsterdam; Department of Rheumatology, Groene Hart Ziekenhuis (GHZ) hospital, Gouda, the Netherlands; Rheumatology Unit, Department of Medicine, DIMED University of Padua, Padua, Italy.R. van den Berg, PhD; M. de Hooge, MSc; P.A. Bakker, MD; F. van Gaalen, MD, PhD, Department of Rheumatology, Leiden University Medical Center; V. Navarro-Compán, MD, Department of Rheumatology, Leiden University Medical Center, and Department of Rheumatology, University Hospital La Paz; K.M. Fagerli, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; R. Landewé, MD, PhD, Amsterdam Rheumatology Center; M. van Oosterhout, MD, PhD, Department of Rheumatology, GHZ hospital; R. Ramonda, MD, Rheumatology Unit, Department of Medicine, DIMED University of Padua; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center.
Monique
M
Reijnierse
From the Department of Rheumatology, and the Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Rheumatology, University Hospital La Paz, Madrid, Spain; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Amsterdam Rheumatology Center, Amsterdam; Department of Rheumatology, Groene Hart Ziekenhuis (GHZ) hospital, Gouda, the Netherlands; Rheumatology Unit, Department of Medicine, DIMED University of Padua, Padua, Italy.R. van den Berg, PhD; M. de Hooge, MSc; P.A. Bakker, MD; F. van Gaalen, MD, PhD, Department of Rheumatology, Leiden University Medical Center; V. Navarro-Compán, MD, Department of Rheumatology, Leiden University Medical Center, and Department of Rheumatology, University Hospital La Paz; K.M. Fagerli, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; R. Landewé, MD, PhD, Amsterdam Rheumatology Center; M. van Oosterhout, MD, PhD, Department of Rheumatology, GHZ hospital; R. Ramonda, MD, Rheumatology Unit, Department of Medicine, DIMED University of Padua; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center.
Désirée
D
van der Heijde
D000328:Adult; D001416:Back Pain / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012446:Sacroiliac Joint / Q000473:pathology*; D025241:Spondylarthritis / Q000473:pathology*; D055815:Young Adult
INFLAMMATION; MAGNETIC RESONANCE IMAGING; SACROILIAC JOINTS; SPONDYLOARTHRITIS