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Abstract Number: 0382

Six-year Results from the Esperanza Cohort: Evaluation of Clinical Features, Disease Activity Measures and Treatment Aspects in Axial and Peripheral Early Spondyloarthritis

Carolina Tornero1, Victoria Navarro-Compán2, raquel almodovar3, Cristina fernández-Carballido4, Azucena Hernández5, Beatriz Joven-Ibáñez6, Xavier Juanola7, M.Lourdes Ladehesa-Pineda8, José Ramón maneiro9, Antoni Juan Mas10, carlos Montilla11, Manuel J Moreno12, Mireia moreno13, José A. pinto14, juan Carlos Quevedo15, José Rosas16, Teresa Ruiz17, Jesús Sanz18 and Eugenio De Miguel19, 1University Hospital La Paz, Madrid, Spain, 2Rheumatology service, Hospital Universitario La Paz-IdiPaz, Madrid, Spain, 3Hospital Universitario Fundación de Alcorcón, Madrid, Spain, 4H. San Juan, Alicante, Alicante, Spain, 5Hospital Virgen de la Salud, Toledo, Spain, 6University Hospital 12 de Octubre, Madrid, Spain, 7Hospital Universitari de Bellvitge, Barcelona, Spain, 8Hospital Universitario Reina Sofía, Córdoba, Spain, 9Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Galicia, Spain, 10Hospital Universitario Son Llàtzer, Palma de Mallorca, Spain, 11Hospital Universitario de Salamanca, Salamanca, Spain, 12Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain, 13Parc Taulí Hospital Universitari. Institut d’Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain, 14Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain, 15Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain, 16Hospital Marina Baixa, Villajoyosa, 17Hospital de Sierrallana, Servicio de Reumatología, Torrelavega, Spain, 18Hospital Universitario Puerta de Hierro, Madrid, Spain, 19Hospital Universitario La Paz, Madrid, Spain

Meeting: ACR Convergence 2021

Keywords: Ankylosing spondylitis (AS), spondyloarthritis, Spondyloarthropathies

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Session Information

Date: Saturday, November 6, 2021

Title: Spondyloarthritis Including PsA – Diagnosis, Manifestations, & Outcomes Poster I: Clinical Aspects of Axial Spondyloarthritis (0357–0386)

Session Type: Poster Session A

Session Time: 8:30AM-10:30AM

Background/Purpose: Esperanza was a multicenter national health program developed to facilitate an early diagnosis of patients with Spondyloarthritis (SpA) in Spain. The main objective of this study is to compare the clinical evolution of patients with axial SpA (axSpA) and peripheral SpA (pSpA) included in this program.

Methods: Patients from the Esperanza cohort fulfilling ASAS criteria for axSpA or pSpA and completed the 6-year follow-up were included. Patients were classified a cording to the predominant symptom. In case of having axSpA and pSpA, they were classified as axSpA. Clinical features, disease activity and treatment aspects at baseline and 6-year visit were evaluated.

Results: Six-year follow-up data from 178 (83.5%) fulfilling ASAS criteria at the final visit were available: 133 (74.7%) for axSpA and 45 for pSpA (25.3%). 118 (66.3%) were males (50.6% with axSpA and 62.2%, pSpA, p=0.4). Patients with axSpA had more frequently positive HLA-B27 (90.5%) vs. (9.5%), p< 0.001. Follow-up clinical features are shown in table 1. At the final visit, both axSpA and pSpA presented an improvement in clinical symptoms, disease activity (CRP, BASDAI, BASDAS and VAS-pt) and quality of life (ASQoL). A worsening of mobility (BASMI) was observed in both groups. The prevalence of uveitis, psoriasis and inflammatory bowel disease (IBD) at baseline was 10.7%, 18% and 5.6%, respectively. At the 6-year visit, the cumulative prevalence (CP) was 14% for uveitis (16.5% in axSpA and 6.7% in pSpA), 22.5% for psoriasis (12.8% in axSpA and 51.1% in pSpA) and 7.9% for IBD (5.3% in axSpA and 15.6% in pSpA). Most of the patients were prescribed NSAIDS at baseline and more patients maintained this treatment at the 6-year visit in axSpA compared with pSpA (96.9% vs 87.5%, p=0.02). At the final visit, a higher percentage with pSpA received csDMARDs in comparison with axSpA (81% vs. 35.7%, p< 0.001). Sixty (44.4%) patients received biologic therapy at the final visit and no differences were observed in their prescription: 43% in axSpA and 48.6% in pSpA(p=0.6).

Conclusion: The early diagnosis of recent-onset SpA achieves a significant improvement in clinical features, disease activity and quality of life in patients with axSpA and pSpA after 6 years of follow-up. Although previous publications revealed a low radiographic progression in this cohort1, the worsening of BASMI must aware clinicians of possible evolutive structural damage.

Reference: 1. Fernández-Carballido et al. RMD Open. 2020 Sep;6(2):e001345


Disclosures: C. Tornero, None; V. Navarro-Compán, Abbvie, 5, Lilly, 5, Novartis, 5, Pfizer, 5, UCB, 5, Janssen, 5; r. almodovar, None; C. fernández-Carballido, None; A. Hernández, None; B. Joven-Ibáñez, AbbVie, 6, 12, Participant in clinical trials, Celgene, 2, 6, Janssen, 2, 6, 12, Participant in clinical trials, Novartis, 2, 6, 12, Participant in clinical trials, MSD, 6, Pfizer, 6, UCB, 2, Lilly, 12, Participant in clinical trials; X. Juanola, None; M. Ladehesa-Pineda, None; J. maneiro, None; A. Mas, None; c. Montilla, None; M. Moreno, None; M. moreno, UCB, 6, Abbvie, 2, 6, Novartis, 2, 6; J. pinto, None; j. Quevedo, None; J. Rosas, None; T. Ruiz, None; J. Sanz, None; E. De Miguel, Roche, 6, 12, Paid instructor, Abbvie, 2, 5, 6, Novartis, 2, 5, 6, 12, Paid instructor, Pfizer, 2, 5, 6, MSD, 6, BMS, 6, UCB, 6, Grunental, 6, Janssen, 6, 12, Paid instructor, Sanofi, 6, Galapagos, 2.

To cite this abstract in AMA style:

Tornero C, Navarro-Compán V, almodovar r, fernández-Carballido C, Hernández A, Joven-Ibáñez B, Juanola X, Ladehesa-Pineda M, maneiro J, Mas A, Montilla c, Moreno M, moreno M, pinto J, Quevedo j, Rosas J, Ruiz T, Sanz J, De Miguel E. Six-year Results from the Esperanza Cohort: Evaluation of Clinical Features, Disease Activity Measures and Treatment Aspects in Axial and Peripheral Early Spondyloarthritis [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/six-year-results-from-the-esperanza-cohort-evaluation-of-clinical-features-disease-activity-measures-and-treatment-aspects-in-axial-and-peripheral-early-spondyloarthritis/. Accessed .
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