COMPARISON OF NON-RADIOGRAPHIC SPONDYLOARTHRITIS VERSUS ANKYLOSING SPONDYLITIS PATIENTS UNDERGOING BIOLOGICAL THERAPY – DATA FROM A ROMANIAN COHORT

Claudia Deaconu,Daniela Opris,Ruxandra Ionescu

doi:10.37897/rjr.2016.4.1

Abstract

Both non-radiographic spondyloarthritis (nr-SpA) and ankylosing spondylitis (AS) are medical conditions that belong to the axial spondyloarthritis spectrum; these two terms reveal the extent of sacroiliitis assessed by conventional x-ray or MRI. According to the latest classification criteria (ASAS, 2009), clinicians are able to differentiate patients with nr-SpA from AS and to follow their disease progression. The present study aims to compare the two patient categories undergoing biological therapy with an anti-TNF agent and indicate distinct disease features. We included 94 patients in treatment with IFX, ADL, ETA or GOL and monitored clinical, biological and disease activity parameters. The nr-SpA subgroup included a higher percentage of female patients; AS patients presented higher values of the CRP at follow-up visits; there were no significant differences between the two groups regarding the HLA-B27 presence, uveitis history or smoking status. Patients with an inactive disease status had a lower BMI, shorter disease duration and an early initiation of biological therapy, so that we suggest a close and regular monitoring of these two entities.

Highlights

The spondyloarthritidis (SpA) group share similar axial manifestations and radiographic changes, with ankylosing spondylitis (AS) being the main representative
The need to establish an early diagnosis advanced the elaboration of a new set of classification criteria (ASAS, 2009) that targeted the identification of nonradiographic forms of the disease [4]
These include as imaging criteria the presence of lesions indicating active, acute inflammation on MRI which are highly indicative of SpA associated sacroiliitis [2]

Summary

Introduction

The spondyloarthritidis (SpA) group share similar axial manifestations and radiographic changes, with ankylosing spondylitis (AS) being the main representative. The typical radiographic finding is sacroiliitis which belongs to the modified New York classification criteria (1984) [1] The latter require the presence of stage 2 to 4 bilateral sacroiliitis or grade 3 to 4 unilateral sacroiliitis for the diagnosis of AS [2]. The need to establish an early diagnosis advanced the elaboration of a new set of classification criteria (ASAS, 2009) that targeted the identification of nonradiographic forms of the disease [4]. These include as imaging criteria the presence of lesions indicating active, acute inflammation on MRI which are highly indicative of SpA associated sacroiliitis [2]

Objectives

Methods

Results