Background Only a few european studies have shown that most of the clinical features and assessments of axial spondyloarthritis (ax-SpA) are similar in patients with/without radiographic changes1. However, some differences might be observed which might be prognostic factors of more severe disease.
Objectives To describe the demographic, clinical, patient reported outcomes (PROs) and treatment characteristics of ax-SpA population in the Corrona registry, a large national cohort of psoriatic arthritis (PsA)/SpA patients in the US.
Methods The study included ax-SpA patients enrolled in the registry between 3/2013–7/2015. Ax-SpA population was further stratified into two cohorts: ankylosing spondylitis (AS) and non-radiographic Axial SpA (nr-axSpA) based on the NY modified criteria for AS (1984) and ASAS criteria for ax-SpA without sacroiliac radiographic changes respectively. Descriptive analyses on patient characteristics (demographics, clinical, patient reported outcomes and treatment) were evaluated at enrollment into the registry. Chi-square and t-tests were used for continuous and categorical variables respectively to evaluate the differences.
Results Of the 407 patients identified with ax-SpA, 310 were diagnosed with AS and 97 with nr-axSpA. Patients with AS were slightly older (mean: 49yrs vs 44 yrs) and mostly males (65% vs 57%) compared to patients with nr-axSpA respectively. Both cohorts had similar functional disability measured by health assessment questionnaire, HAQ (mean: 0.6 vs 0.6), quality of life measured by EQ-5D (mean: 0.7 vs 0.7) and mean percentage of overall activity impairment measured by WPAI (26.8% vs 31.6%). About 7.6% of AS patients had fibromyalgia compared to 9.7% of nr-axSpA (p-value: 0.5). While clinical features (BASDAI, BASFI, ASDAS) did not differ between the AS and nr-axSpA patients, signs of inflammation measured by acute phase reactants were significantly higher in patients with AS compared to nr-axSpA (mean ESR: 14.4 vs 8.9 respectively, p<0.05) (figure 1), which are consistent with other national cohorts (1). In addition, patients with nr-axSpA were more likely to have enthesitis (47.4% vs. 29.0%) and dactylitis (12.4% vs. 9.0%) respectively. Although there were some differences in the history of biologic use (65% and 74% resp.), current biologic use (61.3% and 63.9%) and use of prednisone (5.5% and 6.2%) was similar in both groups.
Conclusions This is the first characterization of axial SpA patients from the US Corrona registry with stratification into ankylosing spondylitis and non-radiographic axial SpA. Patients with nr-axSpA were younger and more likely to be female compared to patients with AS. Both groups had similar clinical characteristics, quality of life, disability and work impairment.
Rudwaleit et al.2009. Arthritis and Rheumatism, Vol. 60, No. 3, March 2009, pp 717–727
Acknowledgement The design, study conduct, and financial support for this analysis was provided by Novartis. Corrona LLC: In the last two years, AbbVie, Amgen, BMS, Crescendo, Genentech, Horizon Pharma USA, Janssen, Eli Lilly, Novartis, Pfizer, and UCB have supported Corrona LLC through contracted subscriptions.
Disclosure of Interest P. Mease Grant/research support from: Celgene, Novartis, Abbvie, Amgen, BMS, Janssen, Lilly, Pfizer, UCB;, Consultant for: Celgene, Corrona, Merck, Novartis, Abbvie, Amgen, BMS, Crescendo, Genentech, Janssen, Lilly, Merck, Pfizer, UCB;, Speakers bureau: Abbvie, Amgen, BMS, Crescendo, Genentech, Janssen, Lilly, Novartis, Pfizer, UCB, C. Karki Employee of: Corrona, LLC, J. Palmer Employee of: Novartis Pharmaceuticals Corporation, M. Liu Employee of: Corrona, LLC, R. Pandurengan Employee of: Corrona, LLC, V. Herrera Employee of: Novartis Pharmaceuticals Corporation, J. Greenberg Shareholder of: Corrona, LLC, Consultant for: AstraZeneca, Celgene, Genentech, Janssen, Novartis and Pfizer, Employee of: Corrona, LLC