Clinical characteristics and influencing factors of hyperkyphosis in a Chinese Cohort with axial spondyloarthritis: a multicentre retrospective study.

OBJECTIVE This study aimed to investigate the clinical characteristics and influencing factors of axial spondyloarthritis (axSpA) hyperkyphosis in a Chinese cohort. METHODS A cross-sectional study was conducted on 607 patients with axSpA attending 12 hospitals across 11 centers from March 2022 to March 2024.Univariate and multivariate logistic regression analyses were used to explore the relevant influencing factors of hyperkyphosis. A nomogram model for impact factor visualisation and spearman correlation analysis was used to analyze the relationship between the influencing factors. RESULTS Multivariable logistic regression revealed that male sex,disease duration,patient global assessment (PGA),erythrocyte sedimentation rate (ESR),the modified stoke spondylitis score（mSASSS）,pharmacological treatment, and ankylosing spondylitis disease activity score-c-reactive protein (ASDAS-CRP) significantly influenced hyperkyphosis(all P < 0.05).Based on the results of the multivariate regression analysis, we constructed a nomogram model for clinical evaluation with an AUC of 0.98 and an accuracy of 0.95.Spearman correlation analysis showed a positive correlation between the spondyloarthritis international society health index (ASAS-HI) and mSASSS (R=0.16, P<0.001), while pharmacological treatment was negatively correlated with disease activity and mSASSS (R=-0.24, -0.18, P<0.001). CONCLUSION Controlling disease activity in the clinic is crucial. Active pharmacological treatment should be employed to delay radiological progression, enhance patients' ASAS-HI, psychological status, and physical functioning. Additionally, strict smoking cessation and weight control are recommended to reduce disability.