AB0503 DISEASE CONTROL IN ANKYLOSING SPONDYLITIS PATIENTS WITH PERIPHERAL ARTHRITIS IN REAL CLINICAL PRACTICE IN SPAIN: MiDAS STUDY RESULTS
Authors: X. Juanola, C. Fernández-Carballido, A. Muñoz Jimenez., J. Sanz, A. Urruticoechea-Arana, P. Moya, J. M. Belzunegui Otano, C. Sanabra, C. Sastré
Journal: Annals of the Rheumatic Diseases (2021)

Background: MIDAS study assessed disease activity in patients (pts) with ankylosing spondylitis (AS) treated in clinical practice in Spain. Objectives: This subanalysis compared disease activity status between AS pts with and without peripheral arthritis (PA). Methods: Observational, non-interventional, cross-sectional, multicenter study. Pts ≥18 years with ≥6 months diagnosis, fulfilling ASAS and modified New York criteria; undergoing treatment ≥3 months. Disease activity was measured by BASDAI and ASDAS-CRP. The number of painful and swollen joints was recorded in AS pts according to the OMERACT recommendations. 1 Results: 313 AS pts included: 251 (80.2%) without PA and 62 (19.8%) with PA (Table 1). The most frequently involved painful joints in pts with PA were knees (29.0%) and hips (25.8%), while the swollen ones were proximal interphalangeal joints of the hands (17.7%), knees (9.7%) and wrists (8.1%). According to BASDAI (Figure 1A), pts with PA showed a higher score 4.2 (2.4) and a lower percentage 58.1% had disease activity controlled (BASDAI&lt;4) than total AS pts (3.1 [2.2] and 64.5%, respectively) and pts without PA (2.8 [2.1] and 70.1%, respectively). According to ASDAS-CRP (Figure 1B), mean (SD) score was 1.9 (1.1) for AS pts, 2.4 (1.1) for pts with PA and 1.8 (1.1) for pts without PA, while 29.4% AS pts, 14.5% pts with PA and 33.1% pts without PA had inactive disease (ASDAS-PCR&lt;1.3). By combining both indices (ASDAS-CRP and BASDAI), 51.8% AS pts showed adequate control (inactive disease/remission) of disease activity, 29.0% of pts with PA and 57.4% of pts without PA. Table 1. Baseline demographic and clinical characteristics of the AS pts AS (n=313 ) AS without PA (n=251 ) AS with PA (n=62 ) Age (years), mean (SD) 50.4 (12.0) 50.1 (11.9) 51.5 (12.5) Sex (male), n (%) 237 (75.7%) 193 (76.9%) 44 (71.0%) Time since diagnosis (years), mean (SD) 15.5 (11.6) 15.4 (11.4) 16.0 (12.6) Time from onset of symptoms to diagnosis (years), mean (SD) 5.0 (7.2) 4.9 (7.1) 5.6 (7.6) Presence of HLA-B*27+, n (%) 245 (78.5%) 197 (78.8%) 48 (77.4%) Family history of AS, n (%) 66 (21.1%) 55 (21.9%) 11 (17.7%) Family history of psoriasis, n (%) 43 (13.7%) 34 (13.5%) 9 (14.5%) Pts previously treated with bDMARD, n (%) 99 (31.6%) 79 (31.5%) 20 (32.3%) Swollen joint count (0-66), mean (SD) 0.1 (0.9) 0.0 (0.0) 0.7 (1.9) Painful joint count (0-68), mean (SD) 0.6 (2.4) 0.0 (0.0) 3.0 (4.7) CRP levels (mg/l), mean (SD) 5.1 (8.2) 4.7 (7.6) 6.7 (10.3) Active disease, n (%)* BASDAI ≥4 111 (35.5%) 26 (41.9%) 75 (29.9%) ASDAS-CRP ≥2.1 133 (42.4%) 93 (37.1%) 40 (64.5%) BASFI, mean (SD) 3.4 (2.7) 3.1 (2.6) 4.5 (2.8) MASES index, mean (SD) 0.2 (0.8) 0.2 (0.7) 0.4 (1.2) SPARCC index, mean (SD) 0.4 (1.1) 0.3 (1.0) 0.6 (1.4) Pts perceived disease control (PASS), n (%) 270 (86.3%) 221 (88.0%) 49 (79.0%) ASAS-HI, mean (SD) 5.8 (4.4) 5.4 (4.2) 7.6 (4.6) *Refers to the percentage of pts with active disease according to BASDAI≥4 and ASDAS-CRP ≥2.1. Figure 1. Disease status according to peripheral joints involvement A )Disease control according to BASDAI B )Disease activity according to ASDAS-CRP Conclusion: Patients of the MiDAS study with peripheral disease showed higher disease activity and worse physical function, suggesting a severe and complex phenotype more than the one of the AS pts without PA. References: [1]J Rheumatol 1993;20:526-91. AS, ankylosing spondylitis; ASDAS-CRP, Ankylosing Spondylitis Disease Activity Score- C-reactive protein; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; PA, peripheral arthritis. Acknowledgements: We thank to MIDAS group investigators and patients included in the study. Disclosure of Interests: Xavier Juanola Speakers bureau: Novartis, Abbvie, Pfizer, Lilly, Consultant of: Novartis, Lilly, Abbvie, Cristina Fernández-Carballido Speakers bureau: I have received lectures fees from Abbvie, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche and UCB., Consultant of: I have worked as a paid consultant for Abbvie, Celgene, Janssen, Lilly, Novartis, Pfizer and UCB., Alejandro Muñoz Jimenez.: None declared., Jesus Sanz Speakers bureau: Abbvie, Janssen-Cilag, Novartis, Lilly, Consultant of: Abbvie, Janssen-Cilag, Novartis, Lilly, Amgen, Grant/research support from: Abbvie, ANA URRUTICOECHEA-ARANA Speakers bureau: Abbvie, Bristol, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer and UCB, Consultant of: Abbvie, Bristol, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer and UCB, Patricia Moya Speakers bureau: Abbvie, Novartis and UCB, Consultant of: Roche, Joaquin Maria Belzunegui Otano Speakers bureau: Lilly, Amgen, Novartis, Abbvie, Janssen., Cristina Sanabra Employee of: Novartis employee, Carlos Sastré Employee of: Novartis employee.