THU0377 THE CARDIOVASCULAR ASSOCIATIONS WITH ENTHESITIS AND DACTYLITIS IN PATIENTS WITH SPONDYLOARTHRITIS: RESULTS FROM THE ASAS-COMOSPA STUDY
Authors: Mohammad H. Derakhshan, Nicola Goodson, Jonathan Packham, Raj Sengupta, Anna Moltó, Helena Marzo-Ortega, Stefan Siebert
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Enthesitis and dactylitis are considered characteristic inflammatory musculoskeletal manifestations of spondyloarthritis (SpA). These manifestations are usually assessed in the context of their assumed underlying specific condition rather than as distinct entities. Data from the ASAS-COMOSPA cohort have recently been shown that duration of SpA disease is associated with higher odds of hypertension particularly in axial SpA (1). <h3>Objectives</h3> To evaluate the possible associations of dactylitis and enthesitis phenotypes with cardiovascular comorbidities in a heterogeneous cohort of patients with SpA. <h3>Methods</h3> ASAS-COMOSPA is a global cross-sectional study assessing comorbidities in 3984 patients with SpA. History of enthesitis or dactylitis was based on self-report with confirmation using the medical records. Associations between dactylitis or enthesitis with hypertension, dyslipidaemia, diabetes, ischemic heart diseases (IHD) and stroke were analysed by separate logistic regression models unadjusted, adjusted for age and sex (models 1), and adjusted for age, sex and BMI (model 2). <h3>Results</h3> The data of 3905 participants were available for analysis. There were 1480 (37.9%) with history of enthesitis and 611 (15.6%) with dactylitis, while 1814 (46.5%) had neither. Presence of dactylitis was associated with hypertension in the univariable analysis [OR=1.68; 95%CI: 1.39– 2.03]. The association remained significant when adjusted for age and sex, but not following further adjustment for BMI (Table). Similarly, enthesitis was associated with hypertension in the univariable analysis [OR=1.36; 95%CI: 1.17-1.59], which remained after adjusted for age and sex, as well as after further adjustment for BMI (Table). Similar associations were seen for dyslipidaemia and dactylitis [OR=1.60; 95%CI: 1.29– 1.98] or enthesitis [OR=1.50; 95%CI: 1.26-1.77], with the association with dactylitis lost after further adjustment for BMI while the association with enthesitis remained significant (Table). While there were significant associations between dactylitis and diabetes [OR: 1.50 (95% CI: 1.07–2.11)], and between enthesitis and diabetes [OR=1.35; 95%CI: 1.02-1.78] in unadjusted models, no associations were seen after adjustments. There were no significant associations between dactylitis or enthesitis and either IHD or stroke (Table). <h3>Conclusion</h3> In patients with SpA, both dactylitis and enthesitis are associated with higher risk of hypertension and dyslipidaemia. The loss of associations with dactylitis with adjustment for BMI could suggest a potential shared underlying metabolic mechanism. <h3>Reference</h3> [1] Derakhshan MH, et al. J Rheumatol 2019;180538 <h3>Disclosure of Interests</h3> Mohammad H. Derakhshan: None declared, Nicola Goodson Grant/research support from: Research support grant from Novartis, Speakers bureau: Paid speaker UCB, Jonathan Packham Consultant for: Educational speaker grant from Abbvie, Raj Sengupta Grant/research support from: Celgene, Novartis, Consultant for: Abbvie, Biogen, Celgene, Novartis, UCB, Speakers bureau: Abbvie, Biogen, Celgene, Novartis, UCB, Anna Moltó: None declared, Helena Marzo-Ortega Grant/research support from: Janssen, Novartis and Pfizer, Consultant for: AbbVie, Celgene, Janssen, Eli-Lilly, Novartis and UCB, Speakers bureau: AbbVie, Celgene, Janssen, Eli-Lilly, Novartis and UCB, Stefan Siebert Grant/research support from: AbbVie, Novartis, Pfizer, Janssen, BMS, Celgene, UCB, and Boehringer Ingelheim, Consultant for: AbbVie, UCB, Pfizer, Janssen, Boehringer Ingelheim, Celgene, and Novartis, Speakers bureau: AbbVie, UCB, Pfizer, Janssen, Boehringer Ingelheim, Celgene, and Novartis