Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose:
Based on the predominant manifestation of the disease, the ASAS classification criteria for spondyloarthritis (SpA) distinguish two clinical forms:
•Axial SpA, including non-radiographic SpA and Ankylosing Spondylitis (AS)
•Peripheral SpA.
Although both forms are considered as part of the same disease, published data are limited, especially in early disease. The purpose of this study is to describe and compare the characteristics of patients fulfilling the ASAS criteria for axial SpA versus peripheral SpA in patients with recent symptoms onset.
Methods:
-Population.- Baseline dataset from the early SpA ESPERANZA cohort was used, with the following referral criteria: Age <45 years, symptoms duration 3-24 months and with inflammatory back pain (IBP) or asymmetrical arthritis or spinal/joint pain plus ≥1 SpA features.
-Inclusion criteria.– Patients fulfilling the ASAS classification criteria for SpA.
-Outcome.- To compare socio-demographic and disease characteristics between patients with axial SpA and patients with peripheral SpA.
-Statistical analyses: Variables were compared using Student t test (continuous) or Chi-square test (categorical).
Results:
Data from 377 patients were analysed. Two hundred ninety (77.2%) patients were classified as axial SpA (109 AS and 182 non-radiolographic SpA) and 86 (22.8%) patients as peripheral SpA. Table 1 shows the results (mean ± SD or relative frequency) for the comparison of demographic and disease characteristics between groups. Age, sex and disease activity scores were similar in both groups. However, axial SpA was more related to a delay in referral time, uveitis and positive HLA-B27 while peripheral SpA was associated with enthesitis, psoriasis, dactylitis and inflammatory bowel disease (IBD).
Conclusion:
Early SpA patients with predominant axial symptoms have a higher delay in the referral to rheumathologist than patients with peripheral symptoms. However, the degree of disease activity is similar in both groups. Uveitis and HLA-B27 are more frequent in patients with predominant axial symptoms while psoriasis, enthesitis, dactylitis and IBD are more frequent in patients with peripheral involvement.
Table 1 shows mean ± SD and p value
|
Characteristic |
Axial SpA N (%)= 291 (77.2) |
Peripheral SpA N (%) = 86 (22.8) |
P value |
|
Age (years) |
32.0 ± 7.0 |
32.8 ± 7.8 |
0.4 |
|
Male |
191 (65.6) |
50 (58.1) |
0.2 |
|
Symptoms duration (months) |
13.0 ± 6.7 |
9.3 ± 6.2 |
<0.001 |
|
Enthesitis |
57 (19.6) |
43 (50) |
<0.001 |
|
Psoriasis |
33 (11.3) |
28 (32.6) |
<0.001 |
|
Dactylitis |
16 (5.5) |
28 (32.6) |
<0.001 |
|
IBD |
9 (3.1) |
10 (11.6) |
0.001 |
|
Uveitis |
23 (7.9) |
1 (1.2) |
0.02 |
|
Diarrhea, cervicitis, urethritis |
11 (3.78) |
5 (5.8) |
0.4 |
|
Family history |
101 (34.7) |
31 (36) |
0.8 |
|
HLA-B27 |
219 (75.3) |
28 (32.6) |
<0.001 |
|
CRP (mg/L) |
10.8 ± 15.2 |
13.7 ± 31.2 |
0.3 |
|
ESR (mmHg) |
13.6 ± 13.5 |
14.1 ± 13.4 |
0.8 |
|
SJC |
0.3 ± 1.3 |
1.4 ± 2.4 |
<0.001 |
|
VAS (0-10) physician |
2.9 ± 2.2 |
2.4 ± 2.1 |
0.1 |
|
VAS (0-10) patient |
4.2 ± 2.7 |
3.1 ± 2.5 |
<0.01 |
|
BASDAI |
3.8 ± 2.3 |
3.5 ± 2.3 |
0.2 |
Disclosure:
P. del Río-Martínez,
None;
V. Navarro-Compán,
None;
C. Castillo-Gallego,
None;
M. C. Castro,
None;
E. Collantes-Estévez,
None;
E. De Miguel,
None.
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