FRI0268 REMISSION IN AXIAL SPONDYLOARTHRITIS: IS THERE A DIFFERENCE BETWEEN NSAIDS AND BIOLOGICS IN THE REAL LIFE?

Abstract

Background:Randomized-controlled trials (RCTs) done in axial spondyloarthritis (AxSpA) patients have shown that remission in AxSpA and nonradiographic axial SpA patients treated without biologics (BIOL) occurs infrequently (Ref 1, 2). Few are known about remission rate (RR) in daily clinical practice.Objectives:Our aim was to assess the remission rate (RR) in AxSpA patients in Real life, and to compare the RR in AxSpA patients on NSAIDs to RR for those on Biologics (TNFα blockers or IL-17A blockers).Methods:This cross-sectional study reviewed clinical data from a single center (St-Luc university hospitals, UCLouvain, Brussels) from 01/2013 to 03/2019. Last visit available for clinical assessment was evaluated. Disease activity was measured using the Bath Ankylosing Spondylitis disease activity index (BASDAI), and the Ankylosing Spondylitis disease activity score (ASDAS) using the C-reactive protein. Remission was defined as BASDAI < 4 and ASDAS < 1.3.Results:Data from 551 AxSpA patients were reviewed. 353 were men (64.3%). In the entire cohort, 478 BASDAI and 317 ASDAS were recorded. The RR according to the BASDAI was 46.7% (n = 223), and 17.3% for the ASDAS (n = 55). To look for the treatment-related RR, we stratified by the treatment (NSAIDs vs Biologics). We had 285 patients on NSAIDs (177 men, 62.5%) and 266 on BIOL (176 men, 66%). 245 BASDAI were available for NSAIDs and 233 for BIOL. 110 patients on NSAIDs (44.9%) and 113 on BIOL (48.5%) were in remission for BASDAI. Regarding ASDAS (table below), data from 172 patients on NSAIDs and 144 on BIOL were available. Out of them, 27 (15.7%) and 28 (19.4%) were in remission for NSAIDs and BIOL respectively. Chi-square test: p = 0.853.Table.Distribution of ASDAS values in both groups.ASDAS<1.3ASDAS≥ 1.3 < 2.1ASDAS≥ 2.1 < 3.5ASDAS> 3.5NSAIDs (n = 172)N = 27 (15.7%)N = 41 (23.8%)N = 70 (40.7%)N = 34 (19.8%)BIOL (n = 144)N = 28 (19.4%)N = 30 (20.8%)N = 57 (39.6%)N = 29 (20.1%)Conclusion:The real life RR in AxSpA seems to be higher on BIOL, even if compared to NSAIDs, the difference is not significant. However, many patients on NSAIDs achieve the remission.