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SAT0279 Patients fulfilling the imaging-arm and patients fulfilling the HLA-B27-arm of the asas axial spondyloarthritis classification criteria: Are they similar?
  1. R. van den Berg1,
  2. M. de Hooge1,
  3. F. van Gaalen1,
  4. M. Reijnierse2,
  5. T. Huizinga1,
  6. D. van der Heijde1
  1. 1Rheumatology
  2. 2Radiology, LUMC, Leiden, Netherlands

Abstract

Background It is possible to classify patients as having spondyloarthritis (SpA) according to the ASAS axial SpA criteria HLA-B27-arm without any signs of sacroiliitis on MRI or X-ray. The question arises whether patients fulfilling the HLA-B27-arm reflect a group of patients similar to those fulfilling the imaging-arm of the ASAS axial SpA criteria1.

Objectives To compare demographics, number of SpA-features and level of disease activity in patients fulfilling the imaging-arm to patients fulfilling the HLA-B27-arm of the ASAS axial SpA criteria.

Methods The SPondyloArthritis Caught Early (SPACE)-cohort is set-up in the Leiden University Medical Center (LUMC) aiming to diagnose and treat patients with axial spondyloarthritis (SpA) at an earlier stage. Patients with back pain (≥3 months, but ≤2 years, onset <45 years) visiting the rheumatology outpatient clinic were included. All patients of the SPACE-cohort (n=157) fulfilling the ASAS axial SpA criteria were included in this analysis (n=60). Patients were compared on demographics, presence of SpA-features and level of disease activity.

Results Of those 60 patients, 29 fulfilled the imaging-arm (11 fulfilling modified New York (mNY) criteria; 18 MRI positive only); 31 fulfilled the HLA-B27-arm. Patients fulfilling the HLA-B27-arm have significantly more often a positive family history for SpA (p=0.001), are more frequently female (p=0.04) and have a significantly shorter disease duration (p=0.02). Moreover, there was a trend toward more uveitis (p=0.09). Patients in both arms are very similar with respect to all other SpA-features and level of disease activity (BASDAI and ASDAS). Within the imaging-arm, patients with sacroiliitis on X-ray do not differ significantly from patients with sacroiliitis on MRI in any of the tested variables including symptom duration and disease activity (table; # represent p-value <0.05).

Conclusions Patients with sacroiliitis on X-ray have the same level of disease activity and symptom duration as patients with sacroiliitis on MRI only. Patients fulfilling the HLA-B27-arm are remarkably similar to patients fulfilling the imaging-arm of the ASAS axial SpA criteria, with respect to the presence of most SpA-features and level of disease activity.

  1. Rudwaleit M et al. ARD 2009;68:777-83

Disclosure of Interest None Declared

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