POS0986 GENDER DIFFERENCES IN DISEASE CONTROL AND HEALTH STATUS IN PATIENTS WITH ANKYLOSING SPONDYLITIS IN CLINICAL PRACTICE IN SPAIN: RESULTS OF THE MiDAS STUDY
Authors: C. Fernández-Carballido, J. Gratacos-Masmitja, E. De Miguel, P. S. Del Río Martínez, O. Martínez González, A. Fernandez-Nebro, P. Vela-Casasempere, C. Sanabra, C. Sastré
Journal: Annals of the Rheumatic Diseases (2021)

Background: Data on disease activity status and health status (HS) in clinical practice in Spain for patients with ankylosing spondylitis (AS) are scarce. The MIDAS study assessed the disease activity and the relationship with the reported HS in patients with AS treated in clinical practice in Spain. Objectives: This is a sub-analysis to evaluate the differences in disease activity and HS by gender of the patients with AS included in the MIDAS study. Methods: MIDAS is an observational, non-interventional, cross-sectional, multicenter study. Patients included were ≥18 years old with ≥6 months since diagnosis, were classified by ASAS and modified New York criteria; undergoing treatment ≥3 months. The primary variable was the disease control assessed by the percentage of patients in remission and low disease activity (measured by BASDAI and ASDAS-CRP) 1-2 . Results: We analyzed 313 AS patients; 237 (75.7%) were male and 76 (24.3%) female (Table 1). Disease control: According to BASDAI &lt;4 (total 64.5% (mean (SD) 3.1 (2.2)); 69.2% (2.9 (2.1)) of the males vs 50.0% (3.8 (2.4)) of the females had a BASDAI &lt;4 (Figure 1A). According to ASDAS-CRP, 57,5% of the AS patients showed low disease activity (ASDAS-ID + ASDAS-LDA), with a mean (SD) ASDAS-CRP of 1.9 (1.1); 138 (58.2%) males and 42 (55.3%) females showed low disease activity (Figure 1B). HS impact was low, with a mean (SD) ASAS-HI of 5.8 (4.4) for AS patients, that was 5.5 (4.4) for males and 6.8 (4.2) for females. Table 1. Baseline demographic and clinical characteristics of the AS patients analysed. Total (n=313 ) Male (n=237 ) Female (n=76 ) Age (years), mean (SD) 50.4 (12.0) 50.1 (12.2) 51.2 (11.5) Years since diagnosis, mean (SD) 15.5 (11.6) 16.8 (12.2) 11.4 (8.5) Years since the symptoms’ onset to the study visit, mean (SD) 20.5 (12.7) 22.2 (13.0) 15.2 (9.9) Years since the symptoms’ onset to diagnosis, mean (SD) 5.0 (7.2) 5.4 (7.7) 3.9 (5.6) BMI (kg/m 2 ), mean (SD) 27.0 (4.9) 27.5 (4.6) 25.5 (5.6) Obesity (BMI&gt;30), n (%) 67 (23.0%) 53 (23.7%) 14 (20.9%) Smoking habit Current smoker, n (%) 75 (24.0%) 61 (25.7%) 14 (18.4%) Ex-smoker (&gt;6 months), n (%) 81 (25.9%) 68 (28.7%) 13 (17.1%) Non-smoker, n (%) 137 (43.8%) 96 (40.5%) 41 (53.9%) Family history of AS, n (%) 66 (21.1%) 48 (20.3%) 18 (23.7%) Presence of HLA-B27, n (%) 245 (78.5%) 187 (79.2%) 58 (76.3%) Patients previously treated with bDMARD 99 (31.6%) 77 (32.5%) 22 (28.9%) Active disease, n (%)* BASDAI ≥4 111 (35.5%) 73 (30.8%) 38 (50.0%) ASDAS-CRP ≥2.1 133 (42.4%) 99 (41.8%) 34 (44.7%) CRP levels (mg/l), mean (SD) 5.1 (8.2) 5.7 (9.0) 3.3 (4.3) PASS, n (%) 270 (86.3%) 208 (87.8%) 62 (81.6%) ASAS-HI, mean (SD) 5.8 (4.4) 5.5 (4.4) 6.8 (4.2) *Refers to the percentage of patients with active disease according to BASDAI≥4 and ASDAS-CRP ≥2.1. AS, ankylosing spondylitis; ASAS-HI, Assessment of Spondyloarthritis International Society - Health index; ASDAS, Ankylosing Spondylitis Disease Activity Score; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; bDMARD: biologic disease modifying anti-rheumatic drug; BMI, body mass index; CRP, C-reactive protein; HLA-B27, human leukocyte antigen B27; PASS, patient acceptable symptom state; SD, standard deviation. Conclusion: Our analysis showed a higher proportion of females with active disease when using the BASDAI definition. However, when using the ASDAS-CRP definition, these differences by gender seem to be less pronounced. Also, the impact of disease activity on the HS seems to be higher in females than males. As far as we know, this is the first Spanish study to evaluate gender in this patient population. References: [1]Smolen JS et al. Ann Rheum Dis 2018;77:3-17 [2]Gratacós J et al. Reumatol Clin 2018;14:320-33 Figure 1. Disease status by sex A )Disease control according to BASDAI B )Disease status according to ASDAS-CRP ASDAS-CRP, Ankylosing Spondylitis Disease Activity Score- C-reactive protein; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index. Acknowledgements: We thank to MIDAS group investigators and patients included in the study. Disclosure of Interests: 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., Jordi Gratacos-Masmitja Speakers bureau: MSD, Pfizer, AbbVie, Janssen Cilag, Novartis, Lilly and Amgen., Consultant of: MSD, Pfizer, AbbVie, Janssen Cilag, Novartis, Lilly and Amgen., Grant/research support from: During the course of the year I have received a private grand from Pfizer. I have not received any private influence in the elaboration of the contents of this talk., Eugenio de Miguel Speakers bureau: AbbVie, Novartis, Pfizer, MSD, BMS, UCB, Roche, Grunental, Janssen, Sanofi., Paid instructor for: Janssen, Novartis, Roche, Consultant of: AbbVie, Novartis, Pfizer, Galapagos, Grant/research support from: Abbvie, Novartis, Pfizer, Pilar Susana Del Río Martínez Speakers bureau: Novartis, Pfizer, Janssen, Sanofi., Paid instructor for: Lilly, Consultant of: Lilly, Sanofi Aventis, Olga Martínez González Speakers bureau: Novartis, Antonio Fernandez-Nebro Speakers bureau: MSD, Pfizer, AbbVie, Janssen Cilag, Novartis, Celgene, GSK, and Lilly, Consultant of: MSD, Pfizer, AbbVie, Janssen Cilag, Novartis, Celgene, GSK, and Lilly, Paloma Vela-Casasempere Speakers bureau: Astra-Zeneca, AbbVie, Boehringer, GSK, Novartis, UCB, Fresenius-Kabi, Sobi and Lilly, Consultant of: Astra-Zeneca, AbbVie, Boehringer, GSK, Novartis, UCB, Fresenius-Kabi, Sobi and Lilly, Grant/research support from: My unit has received also research support from Roche, MSD, Novartis, Lilly, BMS, and Fresenius-Kabi., Cristina Sanabra Employee of: Novartis employee, Carlos Sastré Employee of: Novartis employee.