SAT0266 Use of conventional synthetic dmards and biological dmards in patients with enteropathic spondyloarthritis: a combined gastro-rheumatological approach. (12th June 2018)

• Record Type: Journal Article
• Authors: Chimenti, M.S.; Conigliaro, P.; Triggianese, P.; Canofari, C.; Cedola, F.; Onali, S.; Calabrese, E.; Petruzziello, C.; Ruffa, A.; Monteleone, G.; Biancone, L.; Perricone, R.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 996
• Page End: 997
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.3513
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Enteropathic spondyloarthritis (eSpA) is a chronic autoimmune disease associated with inflammatory bowel disease (IBD) that is poorly diagnosed and managed. Objectives: To assess the diagnostic and therapeutic effect of a combined gastro-rheumatological approach in eSpA patients. Methods: IBD-patients with joint pain referred to a dedicated rheumatologist by gastroenterologist were enrolled. Clinical and biochemical variables, SpA and intestinal disease activity measures, and treatment (biologic; bDMARDs and conventional synthetic; csDMARDs) were recorded at baseline, 3, 6, 12 and 24 months. The association between treatment on demographic and clinical characteristics was evaluated by logistic regression. Results: From a total of 229 IBD patients, 147 (64.2%) were diagnosed with eSpA; 96 (65.3%) showing peripheral involvement and 51 (34.7%) with axial involvement. The majority (67.3%) of eSpA patients were female (n=99), median age and disease duration of 46 and 14.6 years. bDMARD treatment increased over the follow-up period (baseline-24 months: 32.6%>60%; AOR:3.45, 95% CI: 1.93–6.2, p<0.001), however, their use was less frequent in elderly patients (AOR: 0.73, 95% CI: 0.56–0.96, p=0.023), in ulcerative colitis patients (AOR:0.43, 95% CI:0.2–0.94, p=0.034) and in patients with peripheral involvement (AOR:0.53, 95% CI:0.3–1.04, p=0.067). csDMARD use was increased in patients with peripheral involvement (AOR: 4.65, 95% CI:2.09–10.33, p<0.001) and in patient with ulcerative colitis (AOR:2.30, 95% CI:1.13–4.67, p=0.021) (figure 1). CRP, ESR, ASDAS-ESR levels and BASFI were significantly decreased over the follow-up period whereas pMayo score, BASDAI and HAQ-S were unchanged (figure 2). Conclusions: A multidisciplinary approach can improve in the therapeutic management and outcome (e.g. disease activity measures) of eSpA patients. bDMARD use paralleled an improvement in disease measures and confirmed a good safety profile. Disclosure of Interest: None declared