Date: Sunday, October 21, 2018
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
There are many scores available to measure radiographic joint damage in patients with PsA, but most of them were developed for RA and then modified for PsA. These scores don´t evaluate juxtaarticular bone proliferation, which is included as an item in the CASPAR criteria. The aim of our study was to validate the Reductive X-Ray Score for Psoriatic Arthritis (ReXSPA) score in a cohort of patients with PsA.
A cross-sectional study was carried out, patients ≥18 years old with PsA according to CASPAR criteria were included. Sociodemographic data, comorbidities, clinical characteristics, morning stiffness, pain and patient and physician global assessments (by NVS), joint count (66/68), dactylitis, enthesitis (MASES), cutaneous psoriasis (PASI), ESR and CRP were consigned. The self-questionnaires HAQ-A, BASDAI, BASFI, PsAQoL and DLQI were administered. The composite DAPSA and CPDAI indices were calculated and the presence of MDA was assessed. All patients underwent X-rays of the hands and feet in the anteroposterior view. Two blind readers for the clinical characteristics of the patients and previously trained, scored them by Sharp van der Heijde modified for PsA (PsA-SvdHm) and ReXSPA indexes (ICC>0.94). The ReXSPA score evaluates a total of 22 joints in hands and feet. It values joint narrowing and erosion according to PsA-SvdHm and proliferation by Ratingen score. Time to read and calculate both scores were measured. Statistical analysis: Student T and Chi2 test. Spearman correlation. Lineal regression analysis.
A total of 66 patients were included, half of them were female, median (m) age of 56 years (IQR 43-62.3) and m disease duration of 8 years (IQR 4-14.3). 132 X-Rays were scored according to PsA-SvdH [m 35 (IQR: 16.3-72.5)] and ReXSPA [m 22 (IQR: 7-46.3)]. Time to read them was significantly shorter with ReXSPA than PsA-SvdH (mean 5.8±2.1 vs 7.5±2.5 minutes, p<0.0001), as well as, time to calculate them (mean 26.5±14.7 vs 55.3±38.3 seconds, p<0.0001), respectively. The correlation between both indexes was excellent (Rho: 0.93). In the multivariate analysis, using both radiographic scores as dependent variable, the association with disease duration remained significantly associated with both of them, and in the case of ReXSPA also with age.
The ReXSPA index has shown validity and a very good correlation with PsA-SvdH. It is quicker to read and calculate. Subsequent longitudinal evaluations will allow to demonstrate the validity of these findings and to determine if the evaluation of bone proliferation adds an additional advantage.
To cite this abstract in AMA style:Isnardi CA, Schneeberger EE, Dal Pra F, Scheines E, Coronel Ale AL, Fornaro MN, Cerda OL, Citera G. Validation of the Rexspa (Reductive X-Ray Score for Psoriatic Arthritis) in an Argentinean Cohort of Patients with Psoriatic Arthritis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/validation-of-the-rexspa-reductive-x-ray-score-for-psoriatic-arthritis-in-an-argentinean-cohort-of-patients-with-psoriatic-arthritis/. Accessed February 20, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/validation-of-the-rexspa-reductive-x-ray-score-for-psoriatic-arthritis-in-an-argentinean-cohort-of-patients-with-psoriatic-arthritis/