Objectives In patients with early axial spondyloarthritis (SpA) with a disease duration of <5 years and with active inflammation on whole-body magnetic resonance imaging (wb-MRI) in the spine and/or sacroiliac joints (SIJ) at baseline we assessed whether there is a better response to etanercept (ETA) treatment in patients with ankylosing spondylitis (AS) compared to patients with non-radiographic axial SpA (nr-axSpA) [1].

Methods In the previously reported ESTHER trial axial SpA patients (nr-ax SpA, n=20; AS, n=20) were treated over 1 year with ETA [1]. Efficacy data on clinical, laboratory and magnetic resonance imaging of sacroliac joints (SI-joints) and spine response were analysed separately for patients with AS and nr-axSpA [2].

Results At baseline there were no differences between the 20 AS patients and the 20 nr-ax SpA patients regarding age (34.8 (SD 8.2) vs. 34.3 (SD 9.1) years), gender (60.0% vs. 55.0% male), HLA-B27 positivity (90.0% vs. 80.0%), respectively, and parameters of disease activity at baseline (Table 1). Only the MRI-scores were slightly but non-significantly higher in the AS-group. After 48 weeks of treatment with ETA there was a small though non-significant advantage in favor of the nr-axSpA group in nearly all outcome variables (Table 1).

Conclusions There was a similar response in early axial SpA patients treated with ETA, independently whether they belonged to the group of nr-axSpA or AS, with even a slightly better response for nr-axSpA patients. Regarding response rates, short symptom duration seems to matter more than presence or absence of (radiographic) damage.

1. Song I.-H. et al. 2011. Ann Rheum Dis. 2011;70(7):1257-63.

2. Rudwaleit M. et al. 2009. Ann Rheum Dis. 2009 Jun;68(6):777-83.

Disclosure of Interest I.-H. Song Speakers Bureau: Pfizer/Wyeth Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals: consulting fees or other remuneration. K.-G. Hermann: None Declared, H. Haibel Speakers Bureau: Pfizer/Wyeth Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals: consulting fees or other remuneration. C. Althoff: None Declared, D. Poddubnyy Speakers Bureau: Pfizer/Wyeth Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals: consulting fees or other remuneration. J. Listing: None Declared, A. Weiß: None Declared, E. Lange Employee of: Pfizer Germany, B. Freundlich Employee of: former employee from Pfizer/Wyeth, M. Rudwaleit Speakers Bureau: Pfizer/ Wyeth Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals, UCB: consulting fees or other remuneration. J. Sieper Grant/Research support from: Study supported with unrestricted grant from Pfizer/Wyeth, Speakers Bureau: Pfizer/Wyeth Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals, UCB: consulting fees or other remuneration.