Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Axial spondyloarthritis (SpA) are characterized by sacroiliitis. The TNF inhibitors (TNFi) have been proven to be highly effective in ankylosing spondylitis. Recently, adalimumab demonstrate clinical efficacy in patients with axial SpA without radiographically defined sacroiliitis (SI). The objectives of the study are to compare patient’s characteristics and response to treatment according to the presence of SI.
Methods: 162 records of patients with axial SpA treated with TNFi were analyzed. These patients were out and in patients followed in an university hospital in year 2009-2011. Patients have to fulfilled ASAS criteria and treated by at least one TNFi (infliximab, adalimumab, etanercept) to be included. Three groups of patients were designed: group 1: SpA with SI on X-Rays, group 2 : SpA without SI on X-Rays and with SI on magnetic resonance analysis (MRI) and group 3 : SpA without sacroiliitis on X-Rays and MRI. Statistical analysis used univariate, multivariate and survival analysis with GraphPad software.
Results: Characteristics of the patients and results of univariate analysis have been detailed in table 1:
|
Group 1 |
Group 2 |
Group 3 |
1 versus 3 |
1 versus 2 |
2 versus 3 |
|
|
N |
105 |
26 |
31 |
|||
|
Sex (M/F) (%) |
64,7/35,3 |
38,46/61,54 |
38,7/61,3 |
0,01 |
0,014 |
0,98 |
|
Age |
44,38 +/- 13,32 |
44,69 +/-9,18 |
40,93 +/- 11,97 |
0,22 |
0,7 |
0,17 |
|
HLA B27 (%) |
83,8 |
65,38 |
87,1 |
0,65 |
0,035 |
0,052 |
|
Age at diagnostic |
30,64 +/- 11,9 |
37,38 +/-8,1 |
33,03 +/- 9,9 |
0,136 |
0,001 |
0,088 |
|
Increased CRP (%) |
77,1 |
50 |
51,6 |
0,006 |
0,006 |
0,9 |
|
CRP (mg/l) |
31,27 +/- 32,07 |
13,92+/-13,77 |
20,38 +/- 31,88 |
0,013 |
0,007 |
0,96 |
|
TNFi n |
1,33+/- 0,63 |
1,73+/-0,77 |
1,71+/-0,82 |
0,009 |
0,005 |
0,86 |
In multivariate analysis, factors associated statistically with the absence of radiological X-Rays sacroiliitis were (ORs ; 95% confidence intervals) : number of TNFi used (4,154 ; 1,41-12,1 ; p = 0,0032) , age at diagnosis (0,89 ; 0,83-0,96 ; p = 0,0012) and increased of CRP (0,31; 0,14-0,69 ; p = 0,0045). At least the rate of the first TNFi maintenance was significantly (p=0.009) higher in the group 1 (68,5%) compared to group 2 (54.5%) and group 3 (34.6%).
Conclusion:
Presence of sacroiliitis in axial SpA is associated with an earlier diagnosis and more frequent increased CRP as well as a greater maintenance rate of the first TNFi
Disclosure:
J. Girodon,
None;
V. Jouhet,
None;
E. Solau-Gervais,
None.
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