AB0928 CHARACTERISTICS OF AXIAL PSORIATIC ARTHRITIS PATIENTS WITH SYMMETRICAL AND ASYMMETRICAL SACROILIITIS

Abstract

BackgroundThe latest data show that psoriatic arthritis (PsA) patients (pts) with asymmetrical sacroiliitis (SI) have clinical and genetic features which are considered typical for PsA (1).ObjectivesTo analyze comparative clinical characteristics of PsA pts with symmetrical and asymmetrical SI.Methods287 pts (M/F–147/140) with PsA according to CASPAR criteria were examined. Data was collected from 6 rheumatology clinics of the Russian Federation. Pts’ age 45.6±12.2 years (yrs), disease duration 10.9±6.7 yrs. Pts underwent standard clinical examination of PsA activity. Disease activity was measured by DAPSA, BASDAI, ASDAS-СRP. The examination involved determining HLA B27 antigen status and X-rays of sacroiliac joints (SIJs) (pelvic radiographs), hands and feet. Bilateral changes in SIJs of grades 2-2, 3-3 and 4-4 were defined as symmetrical SI (sym-SI). Changes in SIJs of grades 2-1, 2-3, 3-1, 1-4, 2-4 and 3-4 were defined as asymmetrical SI (asym-SI). Skin lesion severity was evaluated in terms of body surface area (BSA) affected and Psoriasis Area Severity Index (PASI). When BSA was ≥ 3%, PASI was calculated. Me [Q25; Q75], Pierson-χ2 tests were performed. All p<0.05 were considered to indicate statistical significance.ResultsSym-SI was found in 187 (65.1%) pts, asym-SI – in 100 (34.8%) pts. In group (gr) of pts with asym-SI there were more females than in the sym-SI gr: 63 (63.0%) vs 77 (41.2%; р = 0.0004). Pts with asym-SI had more severe peripheral arthritis as measured by Tender Joint Count (TJC68) and Swollen Joint Count (SJC66). These values were higher in asym-SI gr: 9 (4-16) vs 6 (2-14; р = 0.007) and 5 (2-12) vs 3 (0-9; р = 0.004), respectively. High activity according to DAPSA was found in 53 (54.6%) pts in the asym-SI gr vs 71 (38.8%) in the sym-SI gr (р = 0.01); low activity and remission by DAPSA– in 16 (16.5%) pts vs 51 (28.3%; р = 0.028), respectively. The frequency of enthesitis was higher in the asym-SI gr: 50 (57.5%) pts vs 57 (38.5%) pts (р = 0.005). Pts’ functional capacity as measured by Health Assessment Questionnaire (HAQ) was worse in the asym-SI gr: HAQ>0.5 values were found in 83 (84.7%) pts vs 130 (72.6%) pts (р = 0.023). No significant differences were found between HLA B27 positivities in sym-SI and asym-SI groups (which were 54.2% and 44.0%, respectively; p = 0.23).ConclusionAsym-SI in PsA pts is associated with female gender, more severe peripheral arthritis, higher activity according to DAPSA, more frequency of enthesitis and reduction of pts’ functional capacity.