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OP0087 The Association of Extra-Articular Manifestations with Disease Duration in Axial Spa: Results from The (Be-) Giant Cohort and The Aspect Study
  1. G. Varkas1,2,
  2. H. Cypers1,2,
  3. N. Vastesaeger3,
  4. L. Van Praet2,
  5. P. Carron2,
  6. F. Van den Bosch2,
  7. D. Elewaut1,2,
  8. on behalf of Be-Giant Consortium
  1. 1VIB Inflammation Research Centre
  2. 2Department of Rheumatology, Ghent University Hospital, Ghent
  3. 3MSD, Brussels, Belgium

Abstract

Background The prevalence of extra-articular manifestations (EAMs) in ankylosing spondylitis (AS) is well-known. However, as the diagnosis of axial spondyloarthritis (AxSpA) is now made much earlier in the disease the prevalence of the EAMs may be different. Moreover, the introduction of anti-TNF therapy may have altered the incidence of EAMs.

Objectives to assess the association of EAMs with disease duration in AxSpA patients (n=215) in the post-anti-TNF era compared to a historic cohort of Belgian AS patients (n=847) from the pre-anti-TNF era.

Methods The BelGian Inflammatory Arthritis and spoNdylitis cohorT (Be-Giant) and The Ghent Inflammatory Arthritis and spoNdylitis cohorT (GIANT) are post-anti-TNF observational cohorts that include consecutive patients since 2010, diagnosed with AxSpA by their treating rheumatologist. Patients who fulfill the ASAS classification criteria, are prospectively followed every 6 months. Follow-up consisted of patient-reported outcomes, a standardized clinical examination (peripheral joints, entheses, axial metrology), standard laboratory analysis and imaging. The ASPECT cohort is a Belgian pre-anti-TNF cross-sectional AS database containing information on 847 patients who fulfilled the New York modified criteria for AS between February 2004 and February 2005.

Results In the (Be-)Giant cohort and ASPECT cohort respectively 47% and 67.9% of patients were male. Mean age was 34.5 (SD 9.6) in the (Be-)Giant cohort and 44.6 (SD 12.1) in the ASPECT cohort. Mean symptom duration was respectively 7.9 and 18.5 years. HLA-B27 was positive in respectively 76.5% and 83% of patients with HLAB27 determination. In a cross-sectional analysis of the baseline data of 215 AxSpA patients from the (Be-) GIANT cohorts, about 66.5% (143/215) of patients had not experienced any EAMs compared to only 58% (491/847) of AS patients in the ASPECT cohort. Additionally, 71.5% (112/144) of patients with a symptom duration of less than 10 years had not experienced any EAMs at baseline in the (Be-)GIANT cohort. However, in patients with more than 10 years of symptom duration, only about half of patients remained EAM- free (P=0.021). Similarly, in patients from the ASPECT cohort with a disease duration of less than 10 years, 70% of patients (304/434) had not experienced any EAM at baseline, whereas only 39% (79/203) of patients remained EAM- free after 20 years of disease. A subanalysis of 118 newly diagnosed non-radiographic AxSpA (nr -AxSpA) patients demonstrated a prevalence of 70.3% (83/118) of EAM-free patients at diagnosis.

Conclusions The prevalence of extra-articular manifestations seems to increase with disease duration both in the pre-anti-TNF and the post-anti-TNF era, and may be linked to longer cumulative exposure to inflammation.

Disclosure of Interest None declared

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