ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2743

Do Specific Entheseal Points in Spa Patients Impact Patient Reported Outcomes? Implications for Clinical Practice

John Kelsall1, Pauline Boulos2, Regan Arendse3, Michelle Teo4, Anna Jaroszynska5, Michael Starr6, Alexander Tsoukas7, Emmanouil Rampakakis8, Eliofotisti Psaradellis9, Karina Maslova10, Cathy Tkaczyk11, Francois Nantel12, Brendan Osborne11 and Allen J Lehman10, 1Rheumatology, University of British Columbia, Vancouver, BC, Canada, 2Rheumatology, McMaster University, Hamilton, ON, Canada, 3University of Saskatchewan, Saskatoon, SK, Canada, 4Rheumatology, Penticton Regional Hospital, Penticton, BC, Canada, 5Private practice, Burlington, ON, Canada, 6Rheumatology, Mcgill University, Pointe-Claire,, QC, Canada, 7McGill University, Montreal, QC, Canada, 8JSS Medical Research, St-Laurent, QC, Canada, 9JSS Medical Research, Montreal, QC, Canada, 10Janssen Inc., Toronto, ON, Canada, 11Medical Affairs, Janssen Inc., Toronto, ON, Canada, 1219 Green belt Dr, Janssen Inc., Toronto, ON, Canada

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: , , ,

Session Information

Date: Tuesday, November 15, 2016

Title: Spondylarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment - Poster III

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:  Previous studies have shown associations between swelling or tenderness of specific joints in RA patients and patient pain. This analysis aimed to describe the impact of enthesitis count and enthesitis profile on functional status (HAQ) and patient global assessment of disease activity (PtGA) among SpA patients treated with anti-TNFs under Canadian routine clinical care.

Methods:  BioTRAC is an ongoing, prospective registry of patients initiating treatment with infliximab (IFX) or golimumab (GLM) for RA, AS, or PsA, or with ustekinumab (UST) for PsA. In this analysis, AS and PsA patients treated with IFX between 2005-2016 or GLM between 2010-2016, and PsA patients treated with UST between 2014-2016, were included. Based on enthesitis location 8 groups were created: suprapsinatus, medial epicondyle humerus, lateral epinondyle humerus, greater trochanter, quadriceps patella, achilles, plantar fascia, and patellar-tibia. The impact of specific entheseal points on HAQ, PtGA, and pain (only for PsA) was assessed with the independent-samples t-test; general linear models were used to assess the relative impact of each location on these outcomes.

Results:  A total of 503 AS patients and 330 PsA patients with 1669 and 1126 assessments, respectively, were included. At baseline, mean (SD) age was 45.4 (13.0) and 51.0 (12.3) years for AS and PsA patients, respectively, and disease duration was 6.6 (9.6) and 5.4 (7.1) years. In terms of disease activity, mean (SD) ASDAS and BASDAI were 3.5 (1.0) and 6.1 (2.2), respectively, whereas, among PsA patients, DAS28 was 4.3 (1.4). Overall, a weak correlation (r<0.4) was observed between enthesitis count and HAQ, PtGA and pain in both AS and PsA patients. Presence of enthesitis at all sites, however, was associated with significantly (P<0.05) higher HAQ and PtGA irrespective of SpA type. Upon adjusting for age and gender, among AS patients, enthesitis at supraspinatus, greater trochanter, and achilles were the main predictors of higher HAQ and PtGA whereas enthesitis at plantar fascia was associated with higher HAQ only. Among PsA patients, medial or lateral epicondyle humerus and greater trochanter were the main predictors of increased HAQ and PtGA, while patellar/tibia was associated with significantly HAQ only.

Conclusion:  Although enthesitis at all sites was associated with significantly higher HAQ and PtGA, individual sites were differentially associated with these outcomes. In AS, supraspinatus, greater trochanter, and achilles were identified as the main predictors of poor patient outcomes, while, among PsA patients, medial/lateral epicondyle humerus and greater trochanter were the most important sites. These results suggest that, in addition to the presence of enthesitis, location of enthesitis may have an impact on patient reported outcomes.

Disclosure: J. Kelsall, Janssen Inc., 5; P. Boulos, Janssen Inc., 5; R. Arendse, Paid Consultant of Janssen Inc., Canada, 5; M. Teo, None; A. Jaroszynska, None; M. Starr, Janssen Inc., 5; A. Tsoukas, Janssen Inc., 5; E. Rampakakis, employee of JSS Medical Research, 3; E. Psaradellis, employee of JSS Medical Research, 3; K. Maslova, Employee of Janssen Inc., 3; C. Tkaczyk, Employee of Janssen Inc., 3; F. Nantel, Employee of Janssen Inc., 3; B. Osborne, Employee of Janssen Inc., 3; A. J. Lehman, Employee of Janssen Inc., 3.

To cite this abstract in AMA style:

Kelsall J, Boulos P, Arendse R, Teo M, Jaroszynska A, Starr M, Tsoukas A, Rampakakis E, Psaradellis E, Maslova K, Tkaczyk C, Nantel F, Osborne B, Lehman AJ. Do Specific Entheseal Points in Spa Patients Impact Patient Reported Outcomes? Implications for Clinical Practice [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/do-specific-entheseal-points-in-spa-patients-impact-patient-reported-outcomes-implications-for-clinical-practice/. Accessed .

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