Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Treatments and diagnosis of SpA is a public health problem. The efficacy of anti-TNF alpha treatment is different from one patient to an other. In 2013, the ASAS society modified the Berlin algorithm, allowing us to define different subgroups of patients. The aim of the study was to compare the anti-TNF alpha response in the eight phenotypes of patients defined by the ASAS modified Berlin algorithm.
Methods: This French retrospective study was performed using the active file of patients suffering of SpA, in the University Hospital of Rouen, since 2005 from 2015, and using an anti-TNF alpha treatment. Patients diagnosed as having SpA by the rhumatologists of the hospital were included. The ASDAS-CRP and BASDAI score were calculated for all the patients at the initiation of the treatment (M0) and one year later (M12). The primary endpoint was the improvment of the ASDAS-CRP score after one year of treatment.
Results: 331 patients were included and distributed according to the modified algorithm (figure 1).69(%) had radiographic sacroiliitis , 117 (35%) had positive MRI, and 149(45%) had positive HLA-B27. All the groups were similar for their average age at the start of the treatment. The duration of the disease was lower in the group 7 (7.2±3 years), higher in group 1 (14.7±11.3 years). The male and female distribution was similar only in the first three groups, the proportion of female were higher in groups 4 to 8 ( Table 1). The ASDAS-CRP and BASDAI scores were significantly improved in all groups excepts in the group6. Nevertheless, the magnitude of this improvment is greater in the groups 1, 2 and 3.In group 1: ASDAS-CRP at M0 was 3.41 and 2.04 at M12 (p<0,0001).In group 2 ASDAS-CRP M0 was 3.12 and 2.15 at M12.(p< 0,0001).In group 3 ASDAS-CRP M0 was 3,1 and 1.9 at M12 (p<0,0001) ( figure 2).
Conclusion: This study demonstrates the heteregeneous response in patients with SpA, distributed according to the modified algorithm of Berlin, after one year of treatment with anti-TNF alpha.This algorithm wich is basically a diagnostic tool, can help us to define the populations of patients for wich anti TNF alpha treatment would be more relevant.