Vitamin D Deficiency Is Associated With a More Active and Severe Disease In Early Axial Spondyloarthritis: Data From The DESIR Cohort

Ihsane Hmamouchi¹, Simon Paternotte², Didier Borderie³ and Maxime Dougados⁴, ¹Biostatistics, Epidemiology LBRCE, Mohamed V Souissi University, Rabat, Morocco, ²Rheumatology Department, Paris- Descartes University, Cochin hospital, Paris, France, ³Laboratoire de Biochimie, Hopital Cochin, Paris Descartes University, Pris, France, ⁴Rheumatology B Department, Paris-Descartes University, APHP, Cochin Hospital, Paris, France

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Activity score, severity and spondylarthritis, Vitamin D

Session Information

Title: Spondylarthropathies and Psoriatic Arthritis: Clinical Aspects and Treatment: II

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Objectives

a) to describe the vitamin D status b) to assess the relationship between vitamin D status and disease activity/severity and c) to estimate the relationship between vitamin D status and comorbidities in an early axial spondyloarthritis (SpA )

Methods:

Patients: 708 patients with early inflammatory back pain suggestive of spondyloarthritis have been included in the DESIR cohort. This analysis was restricted to the patients fulfilling at least one set of criteria for the diagnosis of SpA (e.g. Amor, ESSG or ASAS criteria)

Study design:prospective, multi-centre, observational study

Data collected: 25OHvitD was measured on baseline frozen stored plasma. Radiological and densitometric variables were collected at baseline as well as the cardiovascular risk factors (high-density lipoprotein (HDL) cholesterol, abdominal obesity, triglycerides, blood pressure and fasting glucose) whereas clinical variables (BASDAI, BASFI, BASMI, ASDAS) were collected at each 6 month interval visits during the 2 years follow-up

Data analysis: The 25OHvitD insufficiency threshold was defined by the Vitamin D first quartile. Correlations between this insufficiency and the other variables were done using uni- and multivariate analysis

Results:

A total of 653 patients fulfilling at least one of the criteria for SpA were analysed. A 25OHvitD insufficiency was defined by a value below: 13.29 ng/ml. Such insufficiency was more pronounced in winter (37.1% vs. 9.2%) and in non Caucasian patients (50.8% vs. 22.6%).

After adjusting for season and ethnicity, baseline 25OHvitD remained significantly associated with baseline radiological sacroilitis (1.71 [1.13 – 2.57]), baseline ASDAS crp (1.20 [0.99 – 1.46]), and mean BASMI during the 2 years of follow up (1.46 [0.99 – 2.15]). There was no statistically significant correlation between baseline vitamin D levels and bone densitometry or cardiovascular risk factors.

Conclusion:

These results indicate that high disease activity and severity in early axial SpA is associated with low vitamin D. Further longitudinal studies are required to evaluate the interest of Vit D supplementation on the long term outcome of the disease.

Disclosure:

I. Hmamouchi,
None;

S. Paternotte,
None;

D. Borderie,
None;

M. Dougados,
None.

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