AB0721 EPIDEMIOLOGICAL, CLINICAL AND PROGRESSION FACTORS OF SPONDYLOARTHRITIS IN A TERTIARY CARE HOSPITAL
Authors: Ismael González Fernández, Carlota Iñiguez, Antia Crespo Golmar, Ximena Elizabeth Larco Rojas, Carolina Álvarez Castro, Clara Moriano, Alejandra López Robles, Manuel Martín, Elvira Diez Alvarez, María Eva Vallejo Pascual, Trinidad Pérez Sandoval
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Spondyloarthritis (SpA) is a heterogeneous group of diseases that predominantly affect the axial skeleton, with a debut generally before 45 years. Among the factors favoring radiological progression<sup>1</sup> are, among others, high levels of CRP, tobacco consumption and diagnostic delay. <h3>Objectives:</h3> To describe clinical-epidemiological characteristics and analyze possible factors of radiological progression (based on the development of syndesmophytes) in patients with a diagnosis of SpA in our hospital. <h3>Methods:</h3> Retrospective, descriptive observational study of patients diagnosed with SpA (New York, aSAS and aMOR criteria) in the University Health Care Complex of León for 45 years (1973-2018). <h3>Results:</h3> A total of 218 patients were collected, 59.6% were men and 40.4% were women with an average age of onset of symptoms of 30.56 ± 12.06 years and a diagnosis of 35.59 ± 12.26 (diagnostic delay defined by a median of 2 years before the great dispersion of data). 81.2% have HLA-B27 positive. 64.2% come predominantly León capital, also highlighting other areas such as La Bañeza (9.6%) and astorga (6.4%). 13.8% are ex-smokers, 18.8% are active smokers and 67.4% are non-smokers. 68.3% made their debut with inflammatory low back pain. 67% developed some anterior uveitis throughout its evolution. 72.9% have axial involvement and 27.1% joint axial and peripheral involvement. 89.9% met criteria New York (NY), 8.3% criteria aSAS and 1.8% criteria aMOR for the diagnosis of SpA. 17.4% developed syndesmophytes. The activity of the disease was assessed by BASDAI and PCR (taking the reference point of our laboratory, 5 mg/l as the cut-off point) at the time of diagnosis and in the last control performed, showing that 87.6% presented a BASDAI&gt; 4 at the time of diagnosis while in the last revision 84.9% has BASDAI &lt;4; the elevated levels of CRP appeared in 54.45%, normalizing in 73.9% in the last control. We observed that the age of diagnosis &lt;45 years (p 0.000289) in our sample is related to less progression due to the probable early initiation of biological treatment (18.2% in &lt;45 years, 11% in&gt; 45 years); while both elevated CRP at diagnosis (p 0.003) and exposure to tobacco (p 0.036) present a higher rate of syndesmophytes due to a probable higher inflammatory activity. For other variables (Sex, HLA-B27, BASDAI, diagnostic delay, presence of uveitis and NSAIDs), we did not obtain a statistically significant relationship. <h3>Conclusion:</h3> - Most part of patients with SpA are young men, with HLA-B27 positive and axial involvement with debut as inflammatory back pain that meet NY criteria. - High levels of CRP at diagnosis (p 0.003) and tobacco consumption (p 0.036) have been associated, in our sample, with greater radiological progression while the age of diagnosis &lt;45 years is related to lower progression (p 0, 000289) may be due to the early introduction of biological treatment (18.2% in &lt;45 years, 11% in&gt; 45 years). <h3>References</h3> [1] Poddubny D, Haibel H, Listing J, Märker-Hermann E, Zeidler H, Braun J, et al. Baseline radiographic damage, elevated acute-phase reactant levels, and cigarette smoking status predict spinal radiographic progression. <h3>Disclosure of interests:</h3> None declared