Ankylosing Spondylitis and Non- Radiographic Axial Spondyloarthritis : the Same Syndrome or Different Diseases? Analysis from Esperanza Cohort

Azucena Hernández-Sanz¹, Victoria Navarro-Compán², Cristina Fernández-Carballido³, Carlos Montilla-Morales⁴, Juan Mulero⁵ and Eugenio De Miguel⁶, ¹H. Virgen de la Salud, Toledo, Spain, ²Rheumatology, University Hospital La Paz, Madrid, Spain, ³Rheumatology, University General Hospital Elda, Elda (Alicante), Spain, ⁴H. de Salamanca, Salamanca, Spain, ⁵Rheumatology, University Hospital Puerta de Hierro, Majadahonda (Madrid), Spain, ⁶Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: AS, axial spondyloarthritis, non-radiographic and spondylarthritis

Session Information

Title: Spondyloarthropathies and Psoriatic Arthritis - Clinical Aspects and Treatment III

Session Type: Abstract Submissions (ACR)

Background/Purpose

New ASAS criteria for axial spondyloarthritis (axSpA) have two entrances: the imaging and clinical arm (presence of HLA B27). The imaging arm allows classifying patients as non radiolographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS).

The importance of the concept of nr-axSpA or the clinic arm in the classification of SpA is questioned currently, so it is interesting to investigate how homogeneous or different populations are compared to the classical AS.

Prymary objetive was to compare the characteristics of AS and nr-axSpA of recent onset. Secondary one was to compare the characteristics between groups axial SpA diagnosed by clinical and imaging arm.

Methods

Population: Baseline dataset from the ESPeranza cohort (<45 yrs, symptoms duration 3-24 months and with inflammatory back pain -IBP- or asymmetrical arthritis or spinal/joint pain plus ≥1 SpA features).

Inclusión criteria: Patiens who met ASAS criteria for axSpA.

Variables: Demographic, clinical, activity indices (BASDAI and CRP), mobility (BASMI) and physical function (BASFI) were compared.

Statistical analysis: Results are presented in mean ± standard deviation for continuous variables and n,(%) for categorical variables

Results

A total of 775 patients were included in the “ESperanza” program- From these, 291 met ASAS criteria for axSpA: 194 imaging arm (43.8% nr-axSpA and 56.2 % EA), and 97 clinical arm.

Sixty five percent were male with a mean age of 32 ± 7 years and mean disease duration of 13 ± 6.7 months. Males were more frequently observed in patients with AS compared to nr-axSpA group. Only diarrhea and genito-urinary disease were more frequent in the group of nr-axSpA (Table). Mobility was more impaired in the AS group. No significant differences in the activity or other baseline characteristics were observed. Peripheral and genito-urinary disease, arthritis, enthesitis, uveitis, diarrhea, and family history were significantly more frequent in patients in the clinical arm, while physical function was more impaired in patients on image arm.

Conclusion

Patients with nr-axSpA have very similar clinical features to AS patients in the early stages of the disease, except higher frequency of males and mobility limitation in the AS group.

Patients with axial axSpA in the clinical arm presented more often peripheral involvement that the imaging arm, while no significant differences in the presence of psoriasis and inflammatory bowel disease and activity rates.

Disclosure:

A. Hernández-Sanz,
None;

V. Navarro-Compán,
None;

C. Fernández-Carballido,
None;

C. Montilla-Morales,
None;

J. Mulero,
None;

E. De Miguel,
None.

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/ankylosing-spondylitis-and-non-radiographic-axial-spondyloarthritis-the-same-syndrome-or-different-diseases-analysis-from-esperanza-cohort/