Session Type: Poster Session (Sunday)
Session Time: 9:00AM-11:00AM
Background/Purpose: Peripheral involvement (PI), such as arthritis, enthesitis, and dactylitis, is common in patients with axial spondyloarthritis (axSpA); data showing the influence of PI on radiographic progression of axSpA are controversial. The purpose of this study was to analyze the influence of PI on radiographic structural damage in patients with axSpA.
Methods: A total of 210 patients with axSpA (115 with radiographic and 95 with non-radiographic axSpA) were selected for this analysis. Radiographs of the spine were scored by two trained readers in a randomly selected order according to the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Radiographs of the sacroiliac joint (SIJ) were scored according to the grading system of the modified New York criteria; a sacroiliitis sum score was calculated as a sum of the grades for the left and right SIJ. Mann-Whitney analysis was performed for group comparisons. A multivariable regression analysis was performed to analyze the influence of PI on radiographic spinal progression and progression of radiographic sacroiliitis.
Results: Overall, of the 101 (48.1%) patients with PI (documented history or current presence), 78 had peripheral arthritis, 48 had enthesitis, and 12 had dactylitis. 32 patients had more than 1 periferal manifestation. Patients with PI were older were less frequently human leukocyte antigen (HLA)-B27 positive, compared with patients with no PI (73 (73.0%) vs. 93 (85.3%), p=0.028), more frequently had family history for spondyloarthritis as well as psoriasis, had higher disease activity (time-averaged Ankylosing Spondylitis Disease Activity Score (ASDAS) over 2 years 2.6 ± 0.9 vs. 2.3 ± 0.9; p=0.032), worse physical function, higher exposure to disease modifying anti-rheumatic drugs and lower baseline radiographic sacroiliitis sum score. Patients with a documented history or current presence of PI had lower absolute progression in mSASSS after 2 years than those without (0.28 ± 1.39 vs 1.15 ± 2.9, p=0.045); 7.9% of patients with PI had a progression of mSASSS by ≥2 points compared to 20.2% in patients without PI (p=0.011) – Table 1.
In a multivariable regression analysis, presence of PI was associated with a lower mSASSS progression and lower odds for the mSASSS progression by ≥2 points after 2 years: β=-0.98 (95% -1.68 to -0.28) OR=0.33 (95% CI 0.12 to 0.91), respectively – Table 2.
Conclusion: Presence of PI is associated with distinct characteristics of SpA including slower radiographic spinal progression which might be explained partly by the numerically lower mSASSS score at baseline.
To cite this abstract in AMA style:Torgutalp M, Protopopov M, Proft F, Sieper J, Haibel H, Rudwaleit M, Poddubnyy D. Peripheral Involvement Is Associated with Less Radiographic Spinal Progression in Patients with Early Axial Spondyloarthritis: Results from the German Spondyloarthritis Inception Cohort [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/peripheral-involvement-is-associated-with-less-radiographic-spinal-progression-in-patients-with-early-axial-spondyloarthritis-results-from-the-german-spondyloarthritis-inception-cohort/. Accessed July 6, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/peripheral-involvement-is-associated-with-less-radiographic-spinal-progression-in-patients-with-early-axial-spondyloarthritis-results-from-the-german-spondyloarthritis-inception-cohort/