Date: Friday, November 6, 2020
Session Type: Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: To date, there is no consensus that allows an appropriate definition of axial involvement in PsA, that ranges between 25 to 70%. To estimate the prevalence of axial involvement in patients with newly diagnosed PsA and to describe their characteristics and differences.
Methods: An observational study included patients older than 18 who entered the fast track evaluation program (Reuma-check APS) according to the following criteria: arthritis, dactylitis or enthesitis, associated with psoriasis. Those admitted to the circuit underwent: blood test (VSG and PCR), x-ray and joint and enthesis ultrasound. Sociodemographic data, level of education and habits, DAPSA and HAQ were also recorded. If the patient reported axial symptom was re-entered into an “axial” circuit to collect: date and age of onset, characteristic of low back pain, received NSAIDs and response, VAS of pain, morning stiffness, x-ray and MRI of the sacroiliac, HLA B27, BASDAI and BASFI. The clinical assessor was blinded for the complementary studies that were collected by another observer. Statistical analysis: descriptive statistics was performed and in the low back sample, Chi2 test and Fisher’s exact test and Student or Mann Whitney test was applied, logistic regression.
Results: 75 patients were diagnosed with PsA in the circuit between 2018 and 2019, 55% were women, mean age was 49 (SD 12.5), with a median duration of symptoms until the diagnosis of 3 years (RIC: 5-8).
37% (CI: 25-49) presented clinical axial involvement. The characteristics of low back pain were: inflammatory 76%, sacroiliac test 70%, HLA B27 21%, positive x-ray 40%, MRI 56%, good response to NSAIDs 55%, morning stiffness: 30 mint (15- 40), BASFI 5 (3.8-5.6), BASDAI 4.1 (3-5.8), age of onset 44 (36-50), the time between low back pain and the diagnosis of PsA 4 years (1 -9.7).
In patients with PsA and axial involvement, a higher number of enthesitis was observed median 2 (0-1) vs 0 (0-1) p 0.001, higher DAPSA: median 17 ( 14-19) vs 12 (5-16) p 0.02, and greater functional alteration: HAQ of 0.8 (0.5-1) vs. 0.5 (0.1-1.2). No difference was found regarding sex, smoking, peripheral ultrasound abnormalities, or acute phase reactants. In the logistic regression analysis, only the enthesitis was associated independently.
Conclusion: The prevalence of axial symptoms in our cohort was 37%, the characteristics were mostly inflammatory and with activity by BASDAI. Patients with axial symptoms had more severe PsA characteristics, with greater activity (DAPSA), functional alteration due to HAQ and enthesitis.
To cite this abstract in AMA style:Garcia Salinas R, Ruta S, Torres Chichande J, Sanchez Prado E, Salvatori F, Magri S. Axial Involvement in Psoriatic Arthritis in a Comprehensive Rapid Diagnosis Program (Reuma-check PsA). Analysis of Its Characteristics [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/axial-involvement-in-psoriatic-arthritis-in-a-comprehensive-rapid-diagnosis-program-reuma-check-psa-analysis-of-its-characteristics/. Accessed November 25, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/axial-involvement-in-psoriatic-arthritis-in-a-comprehensive-rapid-diagnosis-program-reuma-check-psa-analysis-of-its-characteristics/