Background ASAS partial remission is relevant treatment target for ankylosing spondylitis (AS) and axial spondyloarthritis (AxSpA) patients.
Objectives Objective of this study was to assess ASAS partial remission ratio during anti-TNF treatment in real life experience. Second objective was to assess related factors of ASAS partial remission at both AS and AxSpA.
Methods HUR-BIO (Hacettepe University Rheumatology Biologic Registry) is a single center biological registry since 2005. HUR-BIO includes patients with AS and AxSpA under anti-TNF drugs. HUR-BIO biological dataset included demographic data, education level, co-morbidities, smoking status. After september 2012, outcome measures of ASAS were recorded regularly every six months or during switched of anti-TNF. Outcome measures of HUR-BIO include BASDAI, BASDAI 2, 5 and 6. questions, BASFI, VAS global, VAS pain, VAS fatique, ESR and CRP. ASAS partial remission was defined as less than 20/100 mm of BASFI, back pain, morning stiffness and VAS global. ASAS partial remission was calculated according to last control visit of patients.
Results There were 874 patients (747 AS and 127 AxSpA) in HUR-BIO dataset. Among 716 of 874 (81.9%) patients [602 (84.1%) and AxSPA 115 (15.9%)] had at least one control visit during last 2 years. Overall, 452 of those 716 (63.1%) patients were male. Mean age (41.3±11.3 vs 35.5±9.7, p<0.001), mean disease duration (9.8±7.3 vs 4.3±2.9, p<0.001), and mean symptom duration (14.3±8.8 vs 7.8±6.6, p<0.001) were higher at AS than AxSpA patients. Initial anti-TNF drugs were etanercept 249 (34.8%), adalimumab 197 (27.5%), infliximab 208 (29.1%) and golimumab 62 (8.6%). Anti-TNF switch was found 207 (28.9%) of patients. ASAS partial remission was found at 205 (28.6%) patients (29.7% vs 22.8%, p=0.13, for AS and AxSpA, respectively). Results of univariate analysis related with ASAS remission was shown at table 1. In logistic regression analysis, positive HLA-B27 OR 3.76 (CI 95% 1.34-10.56, p=0.012), baseline CRP upper than normal limit OR 4.65 (CI 95%, 1.67-12.95, p=0.003) and disease duration less than 5 years OR 0.32 (95%CI 0.14-0.77, P=0.01) were related with ASAS partial remission.
Conclusions At real life experience, ASAS partial remission was reached only almost 29% of AS and 23% of AxSpA patients. We should keep in mind that, almost 20% of patients were not followed in HUR-BIO and analysis was performed only patients with continue anti-TNF treatments. Patients with HLA B27 positive, high baseline CRP and disease duration less than 5 years were candidate for remission.
Disclosure of Interest None declared
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