SAT0371 Hla-B27 Status Is Associated with tnfα Inhibitor Treatment Outcomes in Ankylosing Spondylitis and Non-Radiographic Axial Spondyloarthritis – Observational Cohort Study from The Nationwide Danbio Registry
| Autor: | Lene Dreyer, Anne Gitte Loft, Niels Steen Krogh, Jens Kristian Pedersen, Merete Lund Hetland, Bente Glintborg, Jakob Espesen, N. al Chaer, Johnny Lillelund Raun, Mikkel Østergaard, Lis Smedegaard-Andersen, Oliver Hendricks, Inger Marie Jensen Hansen, Henrik Nordin, Lone Salomonsen, Marcin Ryszard Kowalski, Annette Schlemmer, D. G. A. Kraus, R. Pelck, Laura Danielsen, A. A. Mahamoud, Inge Juul Sørenen, S. R. Christensen |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Ankylosing spondylitis HLA-B27 business.industry Immunology Confounding medicine.disease Logistic regression General Biochemistry Genetics and Molecular Biology Rheumatology Internal medicine Cohort medicine Physical therapy Immunology and Allergy business Spondylitis BASDAI Cohort study |
| Zdroj: | Annals of the Rheumatic Diseases. 75:801.1-801 |
| ISSN: | 1468-2060 0003-4967 |
| DOI: | 10.1136/annrheumdis-2016-eular.2098 |
| Popis: | Background Little is known about tumor-necrosis-factor-alpha-inhibitor (TNFi) treatment outcomes in Ankylosing Spondylitis (AS) vs. non-radiographic axial spondyloartrhitis (nr-axSpA). Objectives To compare baseline disease activity and treatment outcomes in biologic naive patients with AS and nr-axSpA, who initiate TNFi treatment in clinical practice taking potential confounders into consideration. Methods We performed an observational cohort study based on prospectively registered data in the nationwide Danish quality registry, DANBIO, including baseline and 3–6 months9 follow-up markers of disease activity (visual analogue score (VAS) global disease, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), BAS metrology index (BASMI) and serum C-reactive protein (CRP)). Treatment response was defined as either a 50% or a 20 mm reduction in BASDAI after 3–6 mths treatment. We used Kaplan-Meier plots, Cox and logistic regression analyses to study the impact of diagnosis (AS vs. nr-axSpA) and potential confounders (gender, age, start year, HLA-B27, disease duration, TNFi type, smoking, baseline disease activity) on TNFi adherence and response. Numbers are medians (IQR) unless otherwise stated. Results We identified 1,250 TNFi naive patients in DANBIO with axSpA according to the treating physician. Of these, 50% had AS, 28% nr-axSpA and 21% lacked X-rays of sacroiliac joints. Baseline demographics and disease activity differed in nr-axSpA vs. AS (Table). Response rates were similar, but treatment adherence was poorer in nr-axSpA than in AS (univariate, Table). In confounder adjusted analyses, axSpA sub-diagnosis was not associated with response rates or treatment adherence. However, HLA-B27 positivity was associated with better treatment adherence (HLA-B27 neg/pos, nr-axSpA: HR 1.74 (1.29–2.36), AS: HR 2.04 (1.53–2.71.), both p Conclusions In this nationwide cohort, patients with nr-axSpA had higher subjective disease activity at the start of the first TNFi treatment but had similar confounder adjusted treatment adherences and response as AS pts. HLA-B27 positive pts had better outcomes irrespective of axSpA sub-diagnosis. Disclosure of Interest B. Glintborg: None declared, I. Juul Sorensen: None declared, M. Ostergaard: None declared, A. A. Mahamoud: None declared, N. S. Krogh: None declared, L. Andersen: None declared, J. Raun: None declared, O. Hendricks: None declared, M. Kowalski: None declared, L. Danielsen: None declared, S. Christensen: None declared, N. al Chaer: None declared, R. Pelck: None declared, H. Nordin: None declared, J. Pedersen: None declared, D. Kraus: None declared, I. Jensen Hansen: None declared, J. Espesen: None declared, A. Schlemmer: None declared, A. Loft Speakers bureau: MSD, L. Salomonsen: None declared, L. Dreyer: None declared, M. Hetland: None declared |
| Databáze: | OpenAIRE |
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