ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2219

Patients with Ankylosing Spondylitis and Non-Radiographic Axial Spondyloarthritis Show Similar Response Rates After One Year of Treatment with Etanercept –  results of the Esther Trial

In-Ho Song1, Kay-Geert A. Hermann2, Hildrun Haibel1, Christian Althoff3, Denis Poddubnyy4, Joachim Listing5, Anja Weiß6, Ekkehard Lange7, Bruce Freundlich8, Martin Rudwaleit9 and Joachim Sieper10, 1Medical Department I, Rheumatology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany, 2Radiology, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany, 3Radiology, Charite Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany, 4Charité Universitätsmedizin Berlin, Berlin, Germany, 5German Rheumatism Research Center, Berlin, Germany, 6German Rheumatism Research Centre, Berlin, Germany, 7BU Specialty Care, Pfizer Pharma AG, Berlin, Germany, 8University of Pennsylvania, Philadelphia, PA, 9Endokrinologikum Berlin, Berlin, Germany, 10Medical Department I, Rheumatology, Charité Universitätesmedizin Berlin, Berlin, Germany

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: , ,

Session Information

Title: Spondylarthropathies and Psoriatic Arthritis: Clinical Aspects and Treatment

Session Type: Abstract Submissions (ACR)

Background/Purpose: In patients with early axial spondyloarthritis (SpA) with a disease duration < 5 years we assessed whether there is a difference to etanercept (ETA) treatment in patients with ankylosing spondylitis (AS) compared to non-radiographic axial SpA (nr-axSpA). 

Methods: AS (n= 34) and nr-axSpA (n= 32) patients who were treated with ETA for one year were compared for differences in baseline data and treatment effect [1, 2]. Clinical, laboratory and magnetic resonance imaging of sacroiliac joints (SI-joints) and spine were analysed. 

Results:

At baseline there were no significant differences between the 34 AS and the 32 nr-axSpA patients regarding age (34.4 (± 7.7) vs. 33.5 (± 9.2) years), disease duration (4.0 (± 2.2) vs. 3.1 (± 1.8), male gender (55.9% vs. 56.3%), clinical disease activity in terms of BASDAI (5.0 (±2.0) vs. 5.4 (± 1.5), CRP (7.7 (± 8.7) vs. 11.2 (± 13.7)), HLA-B27 (91.2% vs. 75.0%) and MRI SI-joint (6.7 (± 6.2) vs. 5.1 (± 5.4)) and spine scores (2.5 (± 3.6) vs. 1.1 (± 2.1))  in the AS compared to the nr-ax SpA group. After one year of treatment with ETA the treatment effect was similarly good in AS and nr-ax SpA (reduction of BASDAI by 2.1 (95% CI 1.5- 2.7) vs. 2.4 (95% CI 1.8- 2.9) and reduction of ASDAS by 1.3 (95% CI 1.0- 1.5) vs. 1.2 (95% CI 0.9- 1.5), respectively).

Conclusion:

The response rate to TNF-blockers does not differ between AS and nr-ax SpA if the baseline data regarding symptom duration and disease activity are similar for the two groups. 

Table 1: Comparison of Efficacy Parameters between patients with AS and nr-ax SpA after one year of treatment with etanercept

 

Parameter

ETA, AS,

(n= 34)

ETA, nr-ax SpA

(n= 32)

BASDAI50, % (95% CI)

59.4 (42.0 – 76.3)

74.2 (56.9 – 87.4)

ASAS40, %  (95% CI)

68.8 (50.0 – 83.9)

67.7 (50.0 – 83.3)

ASAS partial remission, %      (95% CI)

28.7%

(19.4- 42.5%)

37.9%

(27.7- 51.8%)

ASAS major improvement, %  (95% CI)

24.1 (10.3 – 42.3)

25.0 (10.7 – 44.1)

ASDAS inactive disease (< 1.3), % (95% CI)

27.6%

(18.7- 40.5%)

27.3%

(18.9%- 39.4%)

Change in BASDAI (95% CI)

2.1 (1.5- 2.7)

2.4 (1.8- 2.9)

Change in ASDAS (95% CI)

1.3 (1.0- 1.5)

1.2 (0.9- 1.5)

Change CRP (95% CI)

5.0 (2.3- 7.6)

4.6 (1.9- 7.3)

Change MRI SI-joint score (95% CI)

3.7 (3.0- 4.4)

4.3 (3.6- 5.0)

Change MRI spine score (95% CI)

1.1 (0.6- 1.7)

0.9 (0.3- 1.5)

[1] Song I.-H. et al.  Ann Rheum Dis. 2011;70(7):1257-63.

[2] Song I.-H. et al. Ann Rheum Dis. 2012 Jul;71(7):1212-5.

Disclosure:

I. H. Song,

Pfizer Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals,

5;

K. G. A. Hermann,
None;

H. Haibel,

Pfizer Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals.,

5;

C. Althoff,
None;

D. Poddubnyy,

Pfizer Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceutical,

5;

J. Listing,
None;

A. Weiß,
None;

E. Lange,

Pfizer Inc,

3;

B. Freundlich,

former employee from Pfizer,

3;

M. Rudwaleit,

Abbott, BMS, MSD, Pfizer, Roche, and UCB,

5;

J. Sieper,

Abbott, Merck, Pfizer, and UCB,

2,

Abbott, Merck, Pfizer, and UCB,

5,

Abbott, Merck, Pfizer, and UCB,

8.

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