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AB0717 Clinical Characteristics of Ankylosing Spondyloarthritis in Real Clinical Practice in Russia: Results of A Single Multicenter Non-Interventional Study – Epika 2
  1. T. Dubinina1,
  2. S. Erdes1,
  3. O. Rumyantseva1,
  4. D. Abdulganieva2,
  5. I. Vinogradova3,
  6. L. Evstigneeva4,
  7. A. Yelonakov5,
  8. E. Otteva6,
  9. T. Raskina7,
  10. T. Salnikova8,
  11. R. Samigullina9,
  12. V. Sorotskaya8,
  13. L. Shkil10
  1. 1VA Nasonova Research Institute of Rheumatology, Moscow
  2. 2KSMU, Kazan
  3. 3District Clinical Hospital “1”, Ulianovsk
  4. 4District Rheumatology Center, Ekaterinburg
  5. 5MONIKI, Moscow
  6. 6Regional Clinical Hospital “1” named after Prof Sergeev S.I., Xabarovsk
  7. 7District Clinical Hospital of War Veterans, Kemerovo
  8. 8District Clinical Hospital, Tula
  9. 9NWSMU named after Mechnikov, St. Peterburg
  10. 10MHCI Municipal Clinical Hospital “20” named after Berzon I.S., Krasnoyarsk, Russian Federation

Abstract

Objectives Recognizing the clinical picture of ankylosing spondylitis (AS) in real practice would help to optimize healthcare services provided to this group of pts.

Methods A single multicenter non-interventional study was conducted in spring 2015 y in order to ascertain the clinical features of AS in the real practice of a rheumatologist. 402 consecutive AS pts (meeting modified N-Y criteria) referred to a rheumatologist were evaluated following accepted standards during 2 mo at 10 clinical centers of Russia. All pts were evaluated, including those who addressed because of deterioration, and pts coming for regular check-ups within the disease monitoring.

Results Patients' mean age was 40,8±11,5 y,. 292 (72,6%)- males, 82,6% were HLA-B27- positive. Age at AS onset was 27,6±12,3 y., in 65,4% AS onset occurred before the age of 30 y.o., and in 16,9% – before 16 y.o. Time to establishing the AS diagnosis was 85,2±86,2 mo. By the moment of evaluation inflammatory back pain was present in 55,7% pts, peripheral arthritis - in 33,1%, enthesitis – in 37,1%, dactylitis – in 1,2%. Average BASDAI disease activity score was 4,3±2,1 (in 54,2% of pts it was >4, in 12,7% - >7, and in 18,2% - <2), and BASFI score – 4,1±1,8 (in 48,0% of pts it was >4,in 17,1%,- >7, and in 26,1% - <2). Extraskeletal manifestations were documented in 13,2% AS pts (including uveitis – in 45,3%, psoriasis – in 28,3%, Chrons disease – in 7,5%, IgA-associated neuropathy – in 5,7%, aortitis – in 3,8%). Such complications as amyloidosis were registered in 6 (1,5%) pts, cardiac arrhythmias – in 10 (2,5%) pts, aortal defect – in 1 (0,2%) patient. Most common comorbidities (verified by corresponding specialists) in this population were: arterial hypertension - in 25,1% AS pts, gastric ulcer – in 9,7%, ischemic heart disease – in 4,0%, diabetes mellitus – in 3,0%, chronic bronchitis – in 2,2%, bronchial asthma – in 2,0%, HCV hepatitis – 1,7%, HBV hepatitis – in 1,5%, tuberculosis – in 1,0%, oncologic diseases – in 0,2%, demyelinating conditions – in 0,2% pts. Comorbidities were not found in more than 50% (52%) of pts. Total arthroplasty procedures were documented in 19 (4,7%) pts, including 15 (3,7%) cases of hip replacement, and knee replacement in the rest. By the moment of evaluation another 6,7% of pts required total hip replacement procedure. 92% of pts were taking NSAIDs, sulfasalazine – 31,2%, methotrexate – 11,2%, peroral GCs s - 9,3%, TNF-α inhibitors– 19,1%.

Conclusions In real clinical practice the final AS diagnosis is usually established in more than 7 years after AS onset, by that moment the disease has already reached high activity and pronounced functional impairments occurred. Various comorbidities are found in >40% of AS pts, but with much lower incidence as compared to other systemic rheumatoid diseases.

Disclosure of Interest None declared

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