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FRI0445 Faecal calprotectin, but not anti-saccharomyces cerevisiae antibodies, is linked to worse disease status in axial spondyloarthritis patients without inflammatory bowel disease: results from the spartakus cohort
  1. T Olofsson1,
  2. E Mogard1,
  3. K Andréasson1,
  4. J Marsal2,
  5. M Geijer3,
  6. L-E Kristensen1,4,
  7. E Lindqvist1,
  8. JK Wallman1
  1. 1Department of clinical sciences Lund, Rheumatology
  2. 2Department of clinical sciences Lund, Gastroenterology, Lund University, Lund
  3. 3Department of Radiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
  4. 4The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg and Bispebjerg, Copenhagen, Denmark

Abstract

Background Inflammatory bowel disease (IBD) is a common comorbidity in axial spondyloarthritis.

Objectives To study faecal calprotectin (F-calprotectin) levels and anti-Saccharomyces cerevisiae antibodies (ASCA) and their associations with disease status and gastrointestinal (GI) symptoms in axial spondyloarthritis.

Methods Consecutive patients with a clinical axial spondyloarthritis diagnosis were examined and classified as non-radiographic axial spondyloarthritis (nr-axSpA; Assessment of SpondyloArthritis international Society [ASAS] criteria; n=26) or ankylosing spondylitis (AS; modified New York criteria; n=45). Only patients without known IBD were included. F-calprotectin and ASCA IgA and IgG antibodies in serum were measured by commercially available enzyme-linked immunosorbent assay kits (Calpro AS; ORGENTEC Diagnostika).

Results Elevated levels of F-calprotectin (≥50 mg/kg) were observed in 15% of nr-axSpA and 40% of AS patients (non-significant difference, with reservation for small groups). Overall, worse mean disease activity/disability scores were observed among patients with elevated versus normal F-calprotectin levels (Table), whereas no association was seen between F-calprotectin and GI symptoms. Similar results remained after exclusion of patients with monoclonal antibody type anti-TNF therapy. Elevated levels of ASCA IgA were observed in 8%/2% of nr-axSpA/AS patients, and IgG in 28%/26%. Only 2 subjects were ASCA double positive. Neither disease activity/disability measures nor GI symptoms were associated with ASCA status.

Conclusions Elevated levels of F-calprotectin and ASCA IgG antibodies are both common in axial spondyloarthritis patients without IBD, and elevated F-calprotectin may be a marker of more severe spondyloarthritis. Neither F-calprotectin nor ASCA levels were associated with self-reported GI symptoms.

Disclosure of Interest T. Olofsson: None declared, E. Mogard: None declared, K. Andréasson: None declared, J. Marsal Grant/research support from: AbbVie, Ferring, Hospira, Consultant for: AbbVie, Ferring, Hospira, MSD, Pfizer, Takeda, Tillotts, UCB, M. Geijer: None declared, L.-E. Kristensen Grant/research support from: Oak Foundation, Consultant for: AbbVie, Celgene, BMS, MSD, Novartis, Pfizer, UCB, E. Lindqvist: None declared, J. Wallman Consultant for: Celgene, Novartis, UCB

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