Session Information
Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose:
Enthesitis is one of the potential extra-axial manifestations found in patients with spondyloarthritis (SpA). Enthesitis can be quantified using the MASES (Maastrich Ankylosing Spondylitis Enthesitis Score), consisting 13 pre-defined entheses assessed for tenderness. Evidence regarding treatment of enthesitis is limited. There are no specific recommendations for treatment of enthesitis in SpA. To better understand the impact of enthesitis real live data are needed.
Objective:
To analyse the development of enthesitis under treatment.
Methods:
We included all patients from the Swiss national registry SCQM with axial spondyloarthritis and valid MASES at baseline. Patients were analysed for changes in MASES subsequent to treatment in separate for: (A) MASES 0-13; (B) grouped MASES = 0 vs. MASES 1-5 vs. MASES 6-13; (C) time point in treatment strategy (1st, 2nd vs 3rd therapeutic strategy for treatment of axial SpA); (D) response to synthetical DMARDs vs. biologic agents; (E) response to Etanercept vs. antibody-based TNF antagonists (Adalimumab, Infliximab, Golimumab, and Certolizumab). The results of the correlation analyses were calculated using linear regression. Differences between two groups were compared with the Mann-Whitney U test and between more than two groups with the Kruskal-Wallis test.
Results:
3241 patients were included into the study. 45.9% of the patient had no enthesial affection at baseline (MASES = 0). The average response of MASES after 1 year increase linearly with increasing average MASES scores (slope -0.41, R2 = 0.78). For detailed responses per group please refer to the table.
|
|
Response at 12 (±3) months, number of patients assessed (n)* |
p-value |
|
MASES 0 |
+0.48 (n=667) |
p<0.001 |
|
MASES 1-5 |
-1.02 (n=628) |
|
|
MASES 6-13 |
-3.59 (n=176) |
|
|
1st therapeutic decision |
-1.22 (n=360) |
p=0.163 |
|
2nd therapeutic decision |
-0.62 (n=93) |
|
|
3rd and later therapeutic decision |
-1.35 (n=74) |
|
|
Treatment with TNF antagonists |
-1.15 (n=454) |
p=0.967 |
|
Treatment with synthetical DMARDs |
-1.03 (n=59) |
|
|
Treatment with Etanercept |
-0.97 (n=132) |
p=0.540 |
|
Treatment with antibody-based TNF antagonists |
-1.23 (n=323) |
* Calculated on Patients with available data
Summary:
Patients with a higher MASES developed a significantly better reduction in MASES as compared to patients with lower MASES. Almost one out of two patients with a MASES of 0 at baseline developed an entheseal affection during follow up under treatment. Changes of MASES under TNF antagonist or DMARD treatment did not differ in our cohort. No differences in the therapeutic response to different TNF antagonists were detected.
Conclusion:
Entheseal involvement is a neglected problem in axial SpA patients affecting minimum half of the patients. A focussed therapeutic strategy for entheseal involvement is needed.
To cite this abstract in AMA style:
Mueller R, Kaegi T, Graf N, von Kempis J, Luime JJ. Change of Enthesial Involvement Under Treatment Was Independent from the Therapeutic Strategy in Patients with Axial Spondyloarthritis within the Scqm Cohort [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/change-of-enthesial-involvement-under-treatment-was-independent-from-the-therapeutic-strategy-in-patients-with-axial-spondyloarthritis-within-the-scqm-cohort/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/change-of-enthesial-involvement-under-treatment-was-independent-from-the-therapeutic-strategy-in-patients-with-axial-spondyloarthritis-within-the-scqm-cohort/