Whether early diagnosis of axial spondyloarthritis (axSpA; symptom duration ≤2 years) vs. established axSpA is associated with less long-term spinal radiographic progression, assessed over a mean 11.5 years in the Swiss SCQM registry (2004–2024) using mSASSS scores.
Early axSpA patients had significantly less long-term spinal structural damage than established axSpA patients (−3.85 mSASSS units, 95% CI −7.28 to −0.42; adjusted for baseline damage: −5.70 units, 95% CI −9.31 to −2.09), with the difference becoming apparent 10–15 years after diagnosis.
Observational registry design limits causal inference; treatment was standard of care rather than randomized, introducing potential confounding; the difference only emerged after 10–15 years, requiring very long follow-up to detect.
Diagnosing axSpA within 2 years of symptom onset is linked to meaningfully less spinal structural damage over a decade or more. Clinicians should pursue early identification and treatment of axSpA to help prevent long-term radiographic progression.
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