AB0778 Baseline CRP Level and Response to Infliximab Treatment in Spondyloarthritis

Abstract

BackgroundThe treatment of spondyloarthritis (SpA) is based on cDMARDS (Conventional disease-modifying anti-rheumatic drugs) and bDMARDS (Biologic disease-modifying anti-rheumatic drugs) and aims at remission or low disease activity. Elevated C-reactive protein (CRP) is a good marker of inflammation [1].ObjectivesOur goal was to find a link between the CRP level and the response to infliximab.MethodsRetrospective study was conducted in the rheumatology department at the University Hospital of Fez from January 2011 to January 2021. The patients were recruited according to the ASAS 2009 criteria (Assessment of Spondyloarthritis International Society). A negative CRP is defined as less than or equal to 6mg / L and the ESR (Erythrocyte Sedimentation Rate) according to age. The main criteria for evaluating the response to the biological at 3, 6 and 12 months are: BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and ASDASCRP (Ankylosing Spondylitis Disease Activity Score). The secondary criteria are: global evaluation (EVA) and ESR. They were divided into 2 groups according to the CRP while seeking its link with the response to infliximab and with the other epidemiological, clinical and biological parameters.Results375 SpA patients including 65 on infliximab: 50.8% men and 49.2% women. Mean age was 43.40(±1.86) years. Average duration of evolution was 7.71(±6.33) years. Mean baseline CRP was 35.1(±42.7) mg/L. Mean baseline ASDASCRP was 4.04(±1.49). 77.4% had a good ASDAS CRP response to treatment and 22.6% had no response. 59.7% had a good answer according to BASDAI. The bivariate analysis did not find a significant relationship between the initial CRP and the main treatment response criteria: ASDASCRP (p=1) BASDAI (p=0.14), nor with ESR (p= 0.09) and overall EVA (p=0.1).ConclusionNo relationship was found between baseline CRP and disease remission. Further studies with a larger sample would be needed to discuss these results.