The Influence of Reducing Disease Activity Score on Cervical Spine Deformity in Rheumatoid Arthritis: A Systematic Review

Table 4

Cervical spine deformity and DAS overview.

		Deformity none		AAS		AAS + VS/AAI		VS/AAI		DAS baseline	DAS final
		Baseline	Progression	Baseline	Progression	Baseline	Progression	Baseline	Progression
	Correlation between cervical deformity on cervical spine radiographs and DAS28 from baseline to follow-up
Neva (2000) [18]	176	100% #	AAS 3.4%; AAI 1.1%; SAS 2.8%							5.97^	2.01^
Kauppi (2009) [19]	149	100% #	AAS 9%; AAI 4%; SAS 6%							5.53–5.65	In pts - deformity AUC 3.1; In pts + deformity; AUC 3.6
Kanayama (2010) [6]	47			Mean ADI	Mean ADI , 34% of patients progression of ADI			Mean Ranawat	Mean Ranawat , 21% of patients progression of Ranawat	5.71	Nonprogressive , progressive
Blom (2013) [20]	196	100% (R1)	3 yrs: AAS 4.8%, AAI 0%; 6 yrs: AAS 5.9%, AAI <1%; 9 yrs: AAS 7.3%, AAI <1%; 12 yrs: AAS 8.1%, AAI <1%								Non progressive at 9 yrs: 3.69, progressive at 9 yrs: 3.51
Kaito (2019) [16]	101	50%	None: 92%; AAS 8%	32%	None 19%; AAS 34%; VS 63%; SAS 9%	12%	None 17%; AAS 8%; VS 58%; SAS 25%	7%	None 14%; AAS 14%; VS 71%; SAS 14%
Horita (2019) [21]	49	33%	6% (R2)			67%	24%			In pts – progression in deformity 3.1; In pts + progression in deformity 4.1	In pts – progression in deformity 2.1; In pts + progression in deformity; 3.2
Sandstrom (2020) [22]	85	100%	None: AAS 2.4%; AAI 1.2%; SAS 1.2%							and	< 2.6 (R3)
	Correlation between cervical deformity on cervical spine radiographs and DAS28 in a cross-sectional manner
Neva (2003) [24]	85	100% #	None: 83%; AAS 10%; AAI 5%; SAS 5%							In pts - deformity 3.3; In pts + deformity; 3.5	In pts - deformity 3.5; In pts + deformity; 4.5
Younes (2009) [23], Xcerv	50			22.5%	Na	SAS: 10%	Na	10%	Na	MRI and Xcerv findings together: 36% AAS; In pts with AAS 78% of pts had DAS> 3.2 and in pts without AAS 86% of pts had DAS> 3.2	Na
Younes (2009) [23], MRI				17.5% active synovitis on MRI, 15% fibrous pannus, 30% hypervascular pannus, 20% of patients demonstrated AAS on MRI
Takahashi (2014) [7]	220			36%	Na	SAS: 13%	Na	10%	Na	2.66 [1.02 – 6.96]	Na
	Correlation between presence of atlantoaxial synovitis on MRI and DAS
Zoli (2011) [25]	20	75% no active synovitis		Baseline: 25% active synovitis on MRI						In pts – deformity , in pts + deformity
Carotti (2019) [26]	50			24% active synovitis on MRI (R4)						In pts – Deformity , in pts + deformity

Cervical deformity and DAS at baseline and at the end of follow up. The number of patients in the different studies is indicated as well. (#) presumed percentage, regarding the early onset of RA, (^) calculated from data in the article, () significant difference between patients with and without deformity, () significant difference compared to baseline value; (R1) remark 1: CWK radiograph available: baseline ; 3 years: ; 6 years: ; 9 years: ; 12 years: ; (R2) remark 2: Calculated from data in discussion “In the present study, the percentage of patients with any cervical instability at baseline (65.3% of 49 patients) increased to 69.4% at final follow up”; (R3) remark 3: derived from the results section: “the four patients with cervical spine deformity were in sustained remission during the whole follow-up time”; (R4) remark 4: contradictory details are given in the article varying from “no obvious radiological lesions were evident” to “AAS was observed in two of the 12 patients with synovitis on MRI,” na: not applicable.