AB0666 A COMPARISON OF CLINICAL FEATURES AND PREDICTORS OF TREATMENT RESPONSE IN SPONDYLOARTHRITIS PATIENTS IN THE MIDDLE EAST: A CROSS-SECTIONAL MULTINATIONAL STUDY
Authors: J. Al-Saleh, M. P. Abi Saab, A. Negm, F. Balushi, R. Namas, N. Ziade
Journal: Annals of the Rheumatic Diseases (2020)

Background: Spondylarthritis it is a chronic inflammatory disease with heterogenous clinical features. Its prevalence ranges between 0.2%-2%. Over the years biological therapy has improved work productivity and activity impairment in people with SpA. Unlike in rheumatoid arthritis, the concept of treat-to-target is still debatable among rheumatologist. However, there is a consensus that treatment in patient with SpA should be personalized. There are several challenges in the Middle East that might affect providing personalized medicine to patients with SpA in this region. Objectives: The of objective of the study is to explore factors that interfere with achieving clinical targets in patients with SpA clinical practice in the Middle East. Methods: We conducted a cross-sectional, multicentre study to explore the factors that interfere with achieving clinical targets in SpA patients from four countries in the Middle East (Lebanon, Oman, Qatar, and the United Arab Emirates). A total of 404 patients who attended participating centers from January 2019 to June 2019 and who met the ASAS 2010 classification criteria for axial and peripheral SpA; and were at least 18 years of age were enrolled in the study. We excluded patients with peripheral arthritis only. We extracted demographics, clinical data, and conducted patients survey. We used Compliance Questionnaire for Rheumatology (CQR) is a self-reported adherence measure created specifically for and validated in rheumatic diseases. Demographic data and disease and treatment characteristics were described as median and the 25th–75th interquartile range (IQR). Multiple regression analysis was used to investigate the impact of different factors on ASDAS-CRP in patients with SpA. Statistical analysis was performed using Minitab version 18.1 software. Results: A total of 404 patients initially enrolled in the study, we excluded 95 patients as they had peripheral involvement only. We analysed the data of 309 patients with axial only or axial and peripheral SpA. There median age was 43 years and 53.7% were females. The median disease duration was six years. At the time of the study, 72.1% patients were within the arbitrary clinical target of ASDAS &lt; 2.1. Detail description of the studied population and subgroups outlined in table 1. Enthesitis (OR: 2.9; P value: 0.004), Psoriasis (OR: 2.74; P value: 0.007), low compliance score (OR: -4.36; P value: &lt; 0.0001) and HLA B27 (OR: 2.12; P value: &lt; 0.04) were independent predictors of a higher ASDAS –CRP. Conclusion: Enthesitis, psoriasis, noncompliance, and HLA B27 were independent predictors for ASDAS in our cohort. Table 1. Demographic and clinical characteristics of all patients and for achiever and non-achievers Variables All patients (309 ) Achiever (223 ) Non-achieves (86 ) Age, Median, (IQR) yrs 43, (36-51) 43, (35-51.5) 42, (37-51) Female % 53.7% 54.2% 51.9% Disease Duration, Median, (IQR)yrs 6, (3-9) 6, (2-8) 7.5, (3-10) Patient has medical insurance/ Medical coverage 94.5% 95.0% 93.1% Smoking 13.9% 12.1% 18.6% ASDAS-CRP, Median (IQR) 1.56, (1.24-2.1) 1.56, (1.07-1.6) 2.75, (2.36-3.3) Arthritis 40.1% 36.3% 48.1% Dactylitis 13.6% 11.3% 18.50% Enthesitis 29.1% 22.4% 43.2% Family history of SPA 18.4% 14.3% 25.9% Good response to NSAIDs 21.7% 18.8% 22.2% HLA B27 30.0% 25.6% 40.0% Inflammatory bowel disease 7.1% 7.3% 6.20% Inflammatory low back pain 68.6% 68.1% 69.8% Onycholysis 10.9% 10.7% 11.1% Psoriasis 39.4% 25.1% 40.7% Sacroiliitis (Radiographic) 50.4% 49.8% 51.9% Uveitis 6.1% 4.0% 11.1% SpA- classification Axial 49.8% 55.7% 35.6% Axial &amp; peripheral 50.2% 44.3% 64.4% Acknowledgments: ArLAR 2018 Scientific committee for initiating SpA special interest group meeting Disclosure of Interests: Jamal Al-Saleh Grant/research support from: Novartis, AbbVie, Majid Philippe Abi Saab: None declared, Ahmed Negm Speakers bureau: El-lilly, Farida Balushi: None declared, Rajaie Namas: None declared, Nelly Ziade Speakers bureau: Abbvie, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi