Six-year Results from the Esperanza Cohort: Evaluation of Clinical Features, Disease Activity Measures and Treatment Aspects in Axial and Peripheral Early Spondyloarthritis

Carolina Tornero¹, Victoria Navarro-Compán², raquel almodovar³, Cristina fernández-Carballido⁴, Azucena Hernández⁵, Beatriz Joven-Ibáñez⁶, Xavier Juanola⁷, M.Lourdes Ladehesa-Pineda⁸, José Ramón maneiro⁹, Antoni Juan Mas¹⁰, carlos Montilla¹¹, Manuel J Moreno¹², Mireia moreno¹³, José A. pinto¹⁴, juan Carlos Quevedo¹⁵, José Rosas¹⁶, Teresa Ruiz¹⁷, Jesús Sanz¹⁸ and Eugenio De Miguel¹⁹, ¹University Hospital La Paz, Madrid, Spain, ²Rheumatology service, Hospital Universitario La Paz-IdiPaz, Madrid, Spain, ³Hospital Universitario Fundación de Alcorcón, Madrid, Spain, ⁴H. San Juan, Alicante, Alicante, Spain, ⁵Hospital Virgen de la Salud, Toledo, Spain, ⁶University Hospital 12 de Octubre, Madrid, Spain, ⁷Hospital Universitari de Bellvitge, Barcelona, Spain, ⁸Hospital Universitario Reina Sofía, Córdoba, Spain, ⁹Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Galicia, Spain, ¹⁰Hospital Universitario Son Llàtzer, Palma de Mallorca, Spain, ¹¹Hospital Universitario de Salamanca, Salamanca, Spain, ¹²Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain, ¹³Parc Taulí Hospital Universitari. Institut d’Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain, ¹⁴Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain, ¹⁵Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain, ¹⁶Hospital Marina Baixa, Villajoyosa, ¹⁷Hospital de Sierrallana, Servicio de Reumatología, Torrelavega, Spain, ¹⁸Hospital Universitario Puerta de Hierro, Madrid, Spain, ¹⁹Hospital Universitario La Paz, Madrid, Spain

Meeting: ACR Convergence 2021

Keywords: Ankylosing spondylitis (AS), spondyloarthritis, Spondyloarthropathies

Session Information

Date: Saturday, November 6, 2021

Title: Spondyloarthritis Including PsA – Diagnosis, Manifestations, & Outcomes Poster I: Clinical Aspects of Axial Spondyloarthritis (0357–0386)

Session Type: Poster Session A

Session Time: 8:30AM-10:30AM

Background/Purpose: Esperanza was a multicenter national health program developed to facilitate an early diagnosis of patients with Spondyloarthritis (SpA) in Spain. The main objective of this study is to compare the clinical evolution of patients with axial SpA (axSpA) and peripheral SpA (pSpA) included in this program.

Methods: Patients from the Esperanza cohort fulfilling ASAS criteria for axSpA or pSpA and completed the 6-year follow-up were included. Patients were classified a cording to the predominant symptom. In case of having axSpA and pSpA, they were classified as axSpA. Clinical features, disease activity and treatment aspects at baseline and 6-year visit were evaluated.

Results: Six-year follow-up data from 178 (83.5%) fulfilling ASAS criteria at the final visit were available: 133 (74.7%) for axSpA and 45 for pSpA (25.3%). 118 (66.3%) were males (50.6% with axSpA and 62.2%, pSpA, p=0.4). Patients with axSpA had more frequently positive HLA-B27 (90.5%) vs. (9.5%), p< 0.001. Follow-up clinical features are shown in table 1. At the final visit, both axSpA and pSpA presented an improvement in clinical symptoms, disease activity (CRP, BASDAI, BASDAS and VAS-pt) and quality of life (ASQoL). A worsening of mobility (BASMI) was observed in both groups. The prevalence of uveitis, psoriasis and inflammatory bowel disease (IBD) at baseline was 10.7%, 18% and 5.6%, respectively. At the 6-year visit, the cumulative prevalence (CP) was 14% for uveitis (16.5% in axSpA and 6.7% in pSpA), 22.5% for psoriasis (12.8% in axSpA and 51.1% in pSpA) and 7.9% for IBD (5.3% in axSpA and 15.6% in pSpA). Most of the patients were prescribed NSAIDS at baseline and more patients maintained this treatment at the 6-year visit in axSpA compared with pSpA (96.9% vs 87.5%, p=0.02). At the final visit, a higher percentage with pSpA received csDMARDs in comparison with axSpA (81% vs. 35.7%, p< 0.001). Sixty (44.4%) patients received biologic therapy at the final visit and no differences were observed in their prescription: 43% in axSpA and 48.6% in pSpA(p=0.6).

Conclusion: The early diagnosis of recent-onset SpA achieves a significant improvement in clinical features, disease activity and quality of life in patients with axSpA and pSpA after 6 years of follow-up. Although previous publications revealed a low radiographic progression in this cohort¹, the worsening of BASMI must aware clinicians of possible evolutive structural damage.

Reference: 1. Fernández-Carballido et al. RMD Open. 2020 Sep;6(2):e001345

Disclosures: C. Tornero, None; V. Navarro-Compán, Abbvie, 5, Lilly, 5, Novartis, 5, Pfizer, 5, UCB, 5, Janssen, 5; r. almodovar, None; C. fernández-Carballido, None; A. Hernández, None; B. Joven-Ibáñez, AbbVie, 6, 12, Participant in clinical trials, Celgene, 2, 6, Janssen, 2, 6, 12, Participant in clinical trials, Novartis, 2, 6, 12, Participant in clinical trials, MSD, 6, Pfizer, 6, UCB, 2, Lilly, 12, Participant in clinical trials; X. Juanola, None; M. Ladehesa-Pineda, None; J. maneiro, None; A. Mas, None; c. Montilla, None; M. Moreno, None; M. moreno, UCB, 6, Abbvie, 2, 6, Novartis, 2, 6; J. pinto, None; j. Quevedo, None; J. Rosas, None; T. Ruiz, None; J. Sanz, None; E. De Miguel, Roche, 6, 12, Paid instructor, Abbvie, 2, 5, 6, Novartis, 2, 5, 6, 12, Paid instructor, Pfizer, 2, 5, 6, MSD, 6, BMS, 6, UCB, 6, Grunental, 6, Janssen, 6, 12, Paid instructor, Sanofi, 6, Galapagos, 2.

To cite this abstract in AMA style:

Tornero C, Navarro-Compán V, almodovar r, fernández-Carballido C, Hernández A, Joven-Ibáñez B, Juanola X, Ladehesa-Pineda M, maneiro J, Mas A, Montilla c, Moreno M, moreno M, pinto J, Quevedo j, Rosas J, Ruiz T, Sanz J, De Miguel E. Six-year Results from the Esperanza Cohort: Evaluation of Clinical Features, Disease Activity Measures and Treatment Aspects in Axial and Peripheral Early Spondyloarthritis [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/six-year-results-from-the-esperanza-cohort-evaluation-of-clinical-features-disease-activity-measures-and-treatment-aspects-in-axial-and-peripheral-early-spondyloarthritis/. Accessed .

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