Background Mardird sonographic enthesis index (MASEI) was one of the most wide used scoring systems for peripheral enthesitis. A report ever observed the efficacy of Sulfasalazine for peripheral enthesitis in Ankylosing Spondylitis. However, no reports followed up biological agents treatment for early axial spondyloarthropathy (SpA) by MASEI method so far.
Objectives Our study is to find out whether MASEI is suitable for accurately reflecting the therapy effect of biological agents like Etanercept for early axial SpA.
Methods Ultrasound was performed by 2 observers blinded to the other examinations and the final diagnosis once per 3-months and it is planned to carry on for a year. All cases were diagnosed as early axial SpA fulfilling 2009 classification criteria but not 1996 New York Criteria with sacroilliac X-ray and MRI.US examination referred to MASEI related regions. The count of swollen joint, the count of tender joints, ESR, CRP, PGA, PhGA, BASDI, BASFI, BASMI, MASES, ASDAS were employed to assess disease activity.
Results 1) 95 early axial SpA subjects were finally enrolled in the program. All of them finished 24-week follow up, and 33 of them finished 48-week follow up until now. Mean age was 25.0±5.9 years old, female-male ratio was 0.48:1, and disease duration was 36.3months. Only 2 were negative HLA-B27.
2) The response for Etanercept was pretty good with the evidence of all the indexes above had prominent progress both in 12 week and 24 week except the count of swollen joint between 0w and 12w (paired Wilcoxon test, sig<0.05)
3) The good response for Etanercept was also well reflected by the ultrasonic scores: average sum scores (0w:12w:24w = 26.51:13.57:9.57,), tendon thickness scores (0w:12w:24w = 0.88:0.50:0.58, 12w:24w sig=0.11), structure disturbance scores (0w:12w:24w = 5.94:3.13:2.04), bone erosion scores (0w:12w = 6.49:6.52:6.42), calcification scores (0w:12w:24w = 6.45:3.09:1.98), bursitis scores (0w:12w:24w = 1.44:0.46:0.30), Power Doppler scores (0w:12w:24w = 5.32:1.87:1.25). All the scores above were significantly decreased except tendon thickness score between 12week and 24week and bone erosion scores during half a year.
4) There are no correlations between US scores and all the disease activity indexes at baseline, 12 week or 24 week visit point in early axial SpA perhaps due to the peripheral enthesitis might not reflect the axial circumstance.
Conclusions Though the trial was still carried on for the last half a year, our study proved MASEI assessment is a good tool to supervise the effect of Etanercept for peripheral enthesitis in early SpA.
Disclosure of Interest None declared