Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Extra-articular manifestations (EAMs), such as acute anterior uveitis (AAU), inflammatory bowel disease (IBD), and psoriasis contribute to diagnosis, classification criteria, and choice of treatment in patients with ankylosing spondylitis (AS). Therefore, the aim of the present study is to assess whether the presence of EAMs is associated with more functional disability, worse quality of life (QoL), and more radiographic damage in patients with AS over time.
Methods: Twelve-year follow-up data from all patients included in the Outcome in Ankylosing Spondylitis International Study (OASIS) were used. The presence of EAMs was extracted from medical charts by two independent extractors. Function was assessed by the Bath AS Functional Index (BASFI), and the physical component of the Short Form-36. QoL was assessed by the ASQoL, and EuroQoL. Radiographic damage was assessed by the modified Stoke AS Spinal Score. Time adjusted univariable and multivariable generalized estimating equations analyses were performed to assess whether prevalent and incident EAMs, respectively, were associated with functional disability, QoL, and radiographic damage over time. Patients with prevalent EAMs were excluded from the analysis involving incident EAMs.
Results: 216 Patients were included (154 (71%) men, mean age 43.6 years (SD 12.7), mean symptom duration 20.5 years (SD 11.7), and mean follow-up 8.3 years (SD 4.1)). At baseline, 39 (18%) patients had AAU, 15 (7%) IBD, and 9 (4%) psoriasis (prevalent cases). During follow-up, 19 patients developed AAU, 9 IBD, and 5 psoriasis (incident cases). Psoriasis was excluded from further analyses, because of a low prevalence and incidence in this cohort. Prevalent AAU was univariably associated with more radiographic damage (B=7.19, 95%-Confidence Interval [CI] 0.19 to 14.19, p=0.04) over time, but in a multivariable model this association was no longer significant (B=1.22, 95%-CI -3.81 to 6.26, p=0.64). Prevalent IBD was not associated with any of the clinical outcomes over time. Incident AAU was also not associated with clinical outcomes over time. Incident IBD, however, showed a trend towards worse function (BASFI) over time in a univariable model (B=1.86, 95%-CI -0.08 to 3.80, p=0.06), and also in a multivariable model (B=1.40, 95%-CI -0.04 to 2.84, p=0.06).
Conclusion: Prevalent AAU and IBD at baseline were not associated with a worse course of QoL, function, or radiographic damage over time. However, patients with new-onset IBD tended to have more functional disability over time in comparison with patients who do not develop IBD.
Disclosure:
I. Essers,
None;
S. Ramiro,
None;
C. Stolwijk,
None;
M. Blaauw,
None;
R. Landewé,
AbbVie, Amgen, BMS, Centocor, GSK, Merck, Novartis, Pfizer, Roche, Schering-Plough, UCB, Wyeth,
5,
Rheumatology Consultancy bv,
4;
D. M. van der Heijde,
AbbVie, Amgen, AstraZeneca, BMS, Centocor, Chugai, Covagen, Daiichi, Eli Lilly, GSK, Janssen Biologics, Merck, Novartis, Novo-Nordisk, Otsuka, Pfizer, Roche, Sanofi-Aventis, Schering-Plough, UCB, Vertex,
2,
AbbVie, Amgen, AstraZeneca, BMS, Centocor, Chugai, Covagen, Daiichi, Eli Lilly, GSK, Janssen Biologics, Merck, Novartis, Novo-Nordisk, Otsuka, Pfizer, Roche, Sanofi-Aventis, Schering-Plough, UCB, Vertex,
5,
Imaging Rheumatology BV,
9;
F. van Den Bosch,
None;
M. Dougados,
Pfizer Inc; Abbvie;Novartis,Sanofi,Lilly,UCB,
2,
Pfizer Inc; Abbvie;Novartis,Sanofi,Lilly,UCB,
5;
A. van Tubergen,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/do-extra-articular-manifestations-influence-outcome-in-ankylosing-spondylitis-a-12-year-follow-up-study/