Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: In patients with early axial spondyloarthritis (SpA) with a disease duration < 5 years we assessed whether there is a difference to etanercept (ETA) treatment in patients with ankylosing spondylitis (AS) compared to non-radiographic axial SpA (nr-axSpA).
Methods: AS (n= 34) and nr-axSpA (n= 32) patients who were treated with ETA for one year were compared for differences in baseline data and treatment effect [1, 2]. Clinical, laboratory and magnetic resonance imaging of sacroiliac joints (SI-joints) and spine were analysed.
Results:
At baseline there were no significant differences between the 34 AS and the 32 nr-axSpA patients regarding age (34.4 (± 7.7) vs. 33.5 (± 9.2) years), disease duration (4.0 (± 2.2) vs. 3.1 (± 1.8), male gender (55.9% vs. 56.3%), clinical disease activity in terms of BASDAI (5.0 (±2.0) vs. 5.4 (± 1.5), CRP (7.7 (± 8.7) vs. 11.2 (± 13.7)), HLA-B27 (91.2% vs. 75.0%) and MRI SI-joint (6.7 (± 6.2) vs. 5.1 (± 5.4)) and spine scores (2.5 (± 3.6) vs. 1.1 (± 2.1)) in the AS compared to the nr-ax SpA group. After one year of treatment with ETA the treatment effect was similarly good in AS and nr-ax SpA (reduction of BASDAI by 2.1 (95% CI 1.5- 2.7) vs. 2.4 (95% CI 1.8- 2.9) and reduction of ASDAS by 1.3 (95% CI 1.0- 1.5) vs. 1.2 (95% CI 0.9- 1.5), respectively).
Conclusion:
The response rate to TNF-blockers does not differ between AS and nr-ax SpA if the baseline data regarding symptom duration and disease activity are similar for the two groups.
Table 1: Comparison of Efficacy Parameters between patients with AS and nr-ax SpA after one year of treatment with etanercept
|
Parameter |
ETA, AS, (n= 34) |
ETA, nr-ax SpA (n= 32) |
|
BASDAI50, % (95% CI) |
59.4 (42.0 – 76.3) |
74.2 (56.9 – 87.4) |
|
ASAS40, % (95% CI) |
68.8 (50.0 – 83.9) |
67.7 (50.0 – 83.3) |
|
ASAS partial remission, % (95% CI) |
28.7% (19.4- 42.5%) |
37.9% (27.7- 51.8%) |
|
ASAS major improvement, % (95% CI) |
24.1 (10.3 – 42.3) |
25.0 (10.7 – 44.1) |
|
ASDAS inactive disease (< 1.3), % (95% CI) |
27.6% (18.7- 40.5%) |
27.3% (18.9%- 39.4%) |
|
Change in BASDAI (95% CI) |
2.1 (1.5- 2.7) |
2.4 (1.8- 2.9) |
|
Change in ASDAS (95% CI) |
1.3 (1.0- 1.5) |
1.2 (0.9- 1.5) |
|
Change CRP (95% CI) |
5.0 (2.3- 7.6) |
4.6 (1.9- 7.3) |
|
Change MRI SI-joint score (95% CI) |
3.7 (3.0- 4.4) |
4.3 (3.6- 5.0) |
|
Change MRI spine score (95% CI) |
1.1 (0.6- 1.7) |
0.9 (0.3- 1.5) |
[1] Song I.-H. et al. Ann Rheum Dis. 2011;70(7):1257-63.
[2] Song I.-H. et al. Ann Rheum Dis. 2012 Jul;71(7):1212-5.
Disclosure:
I. H. Song,
Pfizer Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals,
5;
K. G. A. Hermann,
None;
H. Haibel,
Pfizer Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals.,
5;
C. Althoff,
None;
D. Poddubnyy,
Pfizer Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceutical,
5;
J. Listing,
None;
A. Weiß,
None;
E. Lange,
Pfizer Inc,
3;
B. Freundlich,
former employee from Pfizer,
3;
M. Rudwaleit,
Abbott, BMS, MSD, Pfizer, Roche, and UCB,
5;
J. Sieper,
Abbott, Merck, Pfizer, and UCB,
2,
Abbott, Merck, Pfizer, and UCB,
5,
Abbott, Merck, Pfizer, and UCB,
8.
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