AB0828 IS PSORIATIC ARTHROPATHY DIFFERENT WHEN IS ACCOMPANIED BY AXIAL INVOLVEMENT?
Authors: S. M. Rojas Herrera, J. Malave Calzada, I. Braña Abascal, M. Priego Fernandez-Martos, D. Fernandez Lozano, R. Veroz Gonzalez, J. J. Aznar Sanchez, L. M. Chaves Chaparro, E. Chamizo Carmona
Journal: Annals of the Rheumatic Diseases (2020)

Background: Axial involvement in patients diagnosed of Psoriatic arthritis (PsA) in variable in previous studies. Axial involvement (according GRAPPA criteria) is based upon inflammatory spinal symptoms pain with loss of lumbar mobility and the presence of radiological sacroiliitis and other radiographic signs of spondylitis in patients with PsA. Objectives: Evaluate the prevalence of axial involvement in PsA an their clinical features. Methods: All patients included in the monographic PsA consultation database of our second level hospital were analyzed. Demographic, clinical and analytical variables were collected. Statistical analysis was performed using SPPSS v.25 Results: We included 145 patients with PsA (fulfilling CASPAR criteria) with a mean age at diagnosis of 45,4 (±13) years and time of evolution of the disease 9,3 (±6,2) years. The proportion of the affectation types were: peripheral 94 (64,8%), mixta 31 (21,4%) and axial 20 (13,8%). Therefore, 51 (35,2%) patients meet criteria for axial involvement, of with 31 (21,4%) also had associated peripheral involvement. Table 1 shows the differences between patients with and without axial disease. Axial involvement was higher in males than women [OR=2,3 (1,1-4,7), p=0,023]. HLAB27, determined in 106 patients, was more prevalent in axial PsA than in exclusive peripheral patients, 35% and 4,5% respectively [OR=11,3 (3,0-42,7), p&lt;0,0001] We didn’t find any differences in other domains of psoriatic disease or gender. Age at diagnosis was lower in patients with HLA B27 positive [35,6 (±12,3) vs 46,2 (± 12,1) years, p=0,0001] and in the patients with dactylitis [40,2 (11,8) vs 46,7 (13) años, p=0,018] or uveitis [28,7 (8,5) vs 45,8 (12,8) years, p=0,02], respect patients who did not present them, regardless of HLAB27. No differences were found in age between patients with axial o peripheral disease [44,6 (±13,3) vs 45,9 (±12,8) years, p=0,56], neither other domains like skin psoriasis, onicopathy or enthesitis. Patients with axial involvement had overweight (BMI &gt;25) less frequently than peripheral disease [OR=0,4 (0,2-0,8), p=0,01)]. We didn’t find any differences in other comorbidities (arterial hypertension, diabetes, hyperlipemia, hyperuricemia, ischemic heart disease, depression) between patines with axial or peripheral disease. TABLE 1. Differences between axial and peripheral patterns With axial involvement, n=51 Without axial involvement, n=94 OR (IC 95%) p value Age at diagnosis, years (SD) 44,6 (±13,3) 45,9 (±12,8) 0,6 Time of evolution, years (SD) 10 (±6,8) 8,9 (±5,8) 0,3 Men, n (%) 36 (42,9%) 48 (57,1%) 2,3 (1,1-4,7) 0,02 HLAB27, n (%) 14 (82,4%) 3 (17,6%) 11,3 (3,0-42,7) &lt;0,0001 Skin Psoriasis, n (%) 47 (36,4%) 82 (63,6%) 1,7 (0,5-5,6) 0,4 Onicopathy, n (%) 11 (26,2%) 31 (73,8%) 0,6 (0,2-1,2) 0,1 Dactilytis, n (%) 9 (32,1%) 19 (67,9%) 0,8 (0,3-2,0) 0,7 Enthesitis, n (%) 13 (44,8%) 16 (55,2%) 1,7 (0,7-3,8) 0,2 Uveitis, n (%) 2 (66,7%) 1 (33,3%) 3,8 (0,3-42,9) 0,2 Inflammatory bowel disease, n (%) 2 (66,7%) 1 (33,3%) 3,8 (0,3-42,9) 0,2 Hyperlipemia, n (%) 27 (31%) 60 (69%) 0,6 (0,3-1,3) 0,2 BMI &gt;25, n (%) 22 (26,5%) 61 (73,5%) 0,4 (0,2-0,8) 0,01 Hypertension, n (%) 18 (39,1%) 28 (60,9%) 1,3 (0,6-2,6) 0,5 Hyperuricemia, n (%) 16 (39%) 25 (61%) 1,3 (0,6-2,7) 0,5 Smokers, n (%) 13 (50%) 13 (50%) 2,1 (0,9-5,0) 0,08 Ischemic heart disease, n (%) 8 (53,3%) 7 (46,7%) 2,3 (0,8-6,8) 0,1 Depression, n (%) 7 (30,4%) 16 (69,6%) 0,8 (0,3-2,0) 0,6 Diabetes, n (%) 7 (30,4%) 20 (74,1%) 0,6 (0,2-1,5) 0,3 Conclusion: Prevalence of axial involvement in our cohort (35,2%) is found within the data reported in other studies (25-70%). Nevertheless, we found less prevalence of HLAB27 positive than other reports. Patients with HLAB27 positive, dactylitis or uveitis are diagnosed at earlier ages. Disclosure of Interests: None declared