Session Information
Session Type: Abstract Submissions (ACR)
Disease Burden is Similar between Non-Radiographic Axial Spondyloarthritis and Ankylosing Spondylitis and Independent of Gender Influences
Background/Purpose:
Axial spondyloarthritis (SpA) covers both ankylosing spondylitis (AS) with established radiographic changes and non-radiographic axial SpA (nr-axSpA) without definite radiographic sacroiliitis. Clinical characteristics and differences between women and men with nr-axSpA or AS have been documented; however comparison of patients with nr-axSpA and AS within the same genders may provide more data. Registry data revealed similar burden of disease, however baseline characteristics regarding gender distribution and HLA-B27 differ in nr-axSpA from AS. We compared nr-axSpA and AS within the same genders regarding the clinical characteristics in a cohort of patients with axial SpA.
Methods:
A total of 170 consecutive patients diagnosed with axial SpA were studied and clinical and laboratory results were compared between male and female patients in subgroups of nr-axSpA and AS. Standard clinical assessment tools (VAS-pain, global assessment, BASDAI, BASFI, ASQoL and SF-36, ASDAS), laboratory data, existence of inflammation on the sacroiliac and lower-thoracic and lumbar spine MR (blindly assessed), SpA features and comorbidities were used in the analysis.
Results:
Patients with AS (n=96) were predominantly male (79.2%) whereas patients with nr-axSpA (n=74) were predominantly female (55.4%) (p=0.0001). Women with nr-axSpA and AS did not differ in clinical variables except family history for SpA and spinal inflammation on MR (16.7% vs 68.8%, p=0.0001, respectively). Men with nr-axSpA and AS did not differ in clinical variables, except HLA B27, peripheral arthritis, younger age and spinal inflammation of MR (25.0% vs 52.1%, p=0.014, respectively).
Table 1. Comparison between groups for the measured parameters
Women |
Men |
|||||
nr-axSpA (n=41) |
AS (n=20) |
p |
nr-axSpA (n=33) |
AS (n=76) |
p |
|
Age, y |
34.7±9.6 |
38.3±7.1 |
0.142 |
29.7±7.6 |
37.5±8.7 |
0.0001 |
Age at symptom onset, y |
29.5±7.8 |
28.1±8.2 |
0.454 |
24.1±7.7 |
26.9±7.4 |
0.07 |
VAS-pain |
4.7±2.5 |
5.2±2.8 |
0.336 |
4.4±3.0 |
3.8±2.7 |
0.334 |
Physician’s global |
3.7±1.3 |
4.4±1.8 |
0.195 |
3.5±2.3 |
3.4±2.0 |
0.728 |
Patient’s global |
4.6±2.4 |
5.6±2.1 |
0.066 |
4.0±2.8 |
3.9±2.5 |
0.779 |
BASDAI |
3.9±1.9 |
4.3±2.2 |
0.634 |
3.8±2.2 |
3.2±2.3 |
0.255 |
BASFI |
2.2±1.9 |
3.5±2.8 |
0.122 |
1.8±1.9 |
2.6±2.3 |
0.085 |
SF-36 MCS |
51.6±23.3 |
40.2±17.2 |
0.072 |
56.0±22.4 |
58.7±23.2 |
0.575 |
SF-36 PCS |
49.9±22.1 |
42.1±19.9 |
0.213 |
54.7±21.6 |
55.5±23.2 |
0.869 |
ASQoL |
7.7±4.7 |
10.1±6.0 |
0.118 |
5.7±4.9 |
6.6±5.4 |
0.399 |
ASDAS-CRP |
2.7±0.9 |
2.9±0.9 |
0.509 |
2.5±0.9 |
2.7±1.0 |
0.452 |
HLA B27+ve, % |
48.8 |
60.0 |
0.430 |
51.5 |
72.3 |
0.047 |
Smoking, % |
29.3 |
15.0 |
0.224 |
54.5 |
44.7 |
0.346 |
Inflammation-SIJ MR, % |
82.1 |
89.5 |
0.703 |
78.8 |
61.8 |
0.084 |
Uveitis, % |
9.8 |
15.0 |
0.546 |
15.1 |
19.7 |
0.570 |
Psoriasis, % |
2.4 |
10.0 |
0.248 |
9.1 |
3.9 |
0.261 |
Family history,% |
12.2 |
35.0 |
0.035 |
18.8 |
26.7 |
0.382 |
Peripheral arthritis |
24.4 |
15.0 |
0.400 |
28.1 |
11.8 |
0.038 |
Preceding infection, % |
19.5 |
5.0 |
0.134 |
18.8 |
6.6 |
0.056 |
Conclusion:
Results of our cohort confirm the earlier data showing that the burden of disease is similar between nr-axSpA and AS. Although disease burden seem to be independent of gender, men or women with nr-axSpA differ from AS in several clinical aspects including HLA B27, peripheral arthritis, positive family history for SpA and more prevalent inflammation on spinal MR.
Disclosure:
S. Ozgocmen,
None;
E. Kilic,
None;
G. Kilic,
None;
O. Akgul,
None.
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