AB0705 INCIDENCE, TREND AND FACTORS ASSOCIATED WITH AMYLOIDOSIS IN PATIENTS WITH SPONDYLOARTHRITIS IN SPAIN. OBSERVATIONAL STUDY BASED ON THE REGISTRATION OF DISCHARGES OF THE GENERAL HOSPITALS OF THE NATIONAL HEALTH SYSTEM (CMBD). (TREND-ESPA STUDY)
Authors: R. Mazzucchelli, N. Crespí-Villarías, E. Perez-Fernandez, R. Almodovar, J. Quirós, P. Zarco-Montejo
Journal: Annals of the Rheumatic Diseases (2020)

Background: Amyloidosis (AA) is a complication of inflammatory diseases, such as Spondyloarthritis (Spa). It is related to active and long-lasting disease. The treatment of Spa has had a major change in recent years, which has allowed a better control of disease activity. Objectives: Analyze the incidence, trend and factors associated with secondary AA hospitalizations in patients with Spa, in Spain. Methods: Population study based on the analysis of a national administrative database (CMBD) of hospital admissions. Period: 01/01/1999 to 31/12/2015. Study population: patients with diagnosis of Spa who were admitted to any national hospital. Control population: 2 groups have been used as controls: GP: group of the general population (without Spa diagnosis) matched of equal sex, age, year and autonomous community as the study population. RA: all income, in the same period, of patients diagnosed with Rheumatoid Arthritis (RA). Secondary AA admissions were identified by the presence of code 277.3. The trend was analyzed using Generalized Linear Models (MLG). The Odds Ratio (OR) of secondary amyloidosis was calculated in Spa vs GP and Spa vs AR. Results: The database (BD) for analysis consists: 1. Study population: 102,609 admissions with Spa diagnosis. 2: GP: 102,609 admissions matched with the study population. 3. - RA: 320.332 admissions. There was a total of 3,790 admissions with AA diagnosis: 782 (0.79%) at Spa, 74 (0.06%) GP and 2,924 (0.91%) RA. The main clinical-demographic characteristics patients with Spa and AA versus the rest of Spa are shown in the following table: Spa_Amylodosis Spa_without_amyloidosis OR IC95% p -value N (%) 782 (0,72) 101827 (99,28) Mean Age (SD) 55,9 (13,15) 58,9715,5) 0,98 0,98-0,99 p&lt;0,001 Mean Charlson Index (SD) 1,80 (1,34) 1,14(1,81) 1,15 1,12-1,18 p&lt;0,001 ALOS (SD) 12,78 (15,12) 10,57 (15,37) 1,01 1,00-1,008 p&lt;0,001 Male n (%) 596 (75,2) 70792 (66,56) 1,52 1,29-1,79 p&lt;0,001 Dead during admission, n (%) 82 (10,35) 3537 (3,32) 3,35 2,66 -4,22 p&lt;0,001 Areact (%) 20 (2,52) 2178 (2,04) 1,23 0,79-1,93 p=0,318 Spa_EII (%) 81 (10,22) 5238 (4,92) 2,19 1,74-2,77 p&lt;0,001 AS (%) 538 (67,92) 67207 (63,19) 1,23 1,06-1,43 p&lt;0,001 PAs (%) 243 (30,68) 37673 (35,42) 0,8 0,69-0,93 p=0,005 Psoriasis (%) 24 (3,03) 2917 (2,74) 1,1 0,73-1,66 p=0,595 Uveitis (%) 12 (1,51) 542 (0,50) 3,01 1,68-5,34 p&lt;0,001 Diabetes mellitus (%) 34 (4,29) 14822 (13,93) 0,27 0,19 - 0,39 p&lt;0,001 Dementia (%) 3 (0,37) 626 (0,58) 0,64 0,2-2 p=0,638 HTA (%) 185 (23,35) 31395 (29,52) 0,72 0,61 - 0,85 p&lt;0,001 Tabaquismo (%) 56 (7,07) 13283 (12,49) 0,53 0,40 - 0,69 p&lt;0,001 Hiperlipemia (%) 99 (12,5) 17748 (16,68) 0,71 0,57-0,88 p&lt;0,001 TVP (%) 7 (0,88) 648 (0,60) 1,45 0,68-3,07 p=0,351 Depresión (%) 23 (2,90) 5939 (5,58) 0,5 0,33-0,76 p&lt;0,001 Tbc (%) 3 (0,37) 544 (0,51) 0,73 0,23-2,30 p=0,803 The age-adjusted rates (/100,000hab*year) of AA in Spa/GP/RA were 16.72 / 1.40 / 97.87 respectively (19.54 / 1.26 / 139.70 in men and 12.23 / 1.74 / 04.54 in women). Age-adjusted AA rates decreased in both Spa from 19.86/100,000hab*year in 1999, to 9.91 in 2015 and for RA from 131.9 in 1999 to 68.7 in 2015). While in GP increased (from 0.75 in 1999 to 2.87 in 2015). It is estimated a decrease (adjusted by age) in Spa of -4.6% per year and -5.5% in Ra, while in PG there was an increase of 10.2%. The AA OR in Spa vs GP is 10.77 (IC95%: 8,489-13,676). While the AA OR in Spa vs RA was 0.808 (95% CI: 0.747-0.875). Conclusion: In Spain, during the period 1999 to 2015, there has been a decrease in the incidence of AA in patients with Spa and Ra. We estimate a decrease of -4.6% per year in Spa and -5.5% per year in Ra. Being male, AS or Spa_EII, and uveitis are associated with AA. Disclosure of Interests: Ramón Mazzucchelli: None declared, Natalia Crespí-Villarías: None declared, Elia Perez-Fernandez: None declared, RAQUEL ALMODOVAR Speakers bureau: Abbvie, Celgene, Janssen, Lilly, Novartis, Pfizer. , Javier Quirós: None declared, Pedro Zarco-Montejo Speakers bureau: Abbvie, MSD, Novartis, Pfizer.