Welcome to the 2021 LUPUS CORA Meeting Program Scheduling
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CORA Topics || ASL25 PSORIATIC ARTHRITIS, CORA Topics || ASL30 SPONDYLOARTHRITIS, CORA Topics || ASL31 SPONDYLOARTHROPATHIES, No Topic Needed
- Roberta Ramonda (Italy)
Introduction by Chairperson
- Roberta Ramonda (Italy)
Did the understanding and treatment of non-radiographic axSpA add anything to our management of spondylarthritis? YES: nr-axSpA gave a new view new drugs etc
- Xenofon Baraliakos (Germany)
Did the understanding and treatment of non-radiographic axSpA add anything to our management of spondylarthritis? NO: we did not learn anything advanced axSpA is the same
- Dennis McGonagle (United Kingdom)
Live rebuttal
- Xenofon Baraliakos (Germany)
Live rebuttal
- Dennis McGonagle (United Kingdom)
Panel discussion – Live
COULD SKIN PSORIASIS INFLUENCE RADIOGRAPHIC SPINAL AND PELVIC PROGRESSION IN EARLY AXIAL SPONDYLOARTHITIS? RESULTS FROM THE ITALIAN ARM OF SPONDYLOARTHRITIS-CAUGHT-EARLY (SPACE) STUDY DURING 48-MONTHS FOLLOW-UP.
- Mariagrazia Lorenzin (Italy)
Abstract
Background and Aims
We aimed to analyze the influence of skin psoriasis on spinal/ pelvic radiographic progression in early axial spondyloarthritis (axSpA) patients.
Methods
Baseline data from the Italian arm of SPondyloArthritis-Caught-Early-cohort, including patients with chronic back pain (CBP; duration≥3 months and ≤2 years, onset<45 years) were analysed. Patients underwent a diagnostic work-up, including MRI and radiograph of the sacroiliac joints (SIJ), to establish a diagnosis of axSpA (according ASAS criteria). Clinical features, disease-activity and functional indices, imaging were collected at baseline and yearly during 48-months. Spinal and SIJ X-rays were scored by 2 readers following mSASSS and mNY-criteria. Characteristics of axSpA patients with/without psoriasis were compared over-time with descriptive statistics; multivariate-logistic-regression model was constructed to assess predictors of spinal and SIJ radiographic progression at 48-months.
Results
Out of 95 CBP patients, 88 had axSpA (84.09% non-radiographic;15.91% radiographic) and 36.36% had psoriasis. At baseline patients with psoriasis were older and less frequently HLA-B27+ compared to those without, had higher prevalence of peripheral arthritis/dactylitis/enthesitis, had less frequently radiographic sacroiliitis with unilateral and asimmetric pattern and more signs of spondylitis (Table 1). A downward trend in functional and disease-activity indices was observed, with higher BASDAI and BASFI in axSpA with psoriasis. A slight radiographic progression in SIJ/spine was observed in all patients. Patients without psoriasis had higher sacroiliitis progression and lower spinal progression than those with psoriasis(Fig.1). Skin psoriasis was a predictor of spinal progression (OR=0.18; 95%CI:0.04-0.78).
Conclusions
Presence of psoriasis is associated with distinct characteristics of axSpA including higher radiographic spinal progression and lower radiographic sacroiliitis.
Live Q&A
THE GENETIC CONTRIBUTION TO DRUG RESPONSE IN SPONDYLOARTHRITIS: A SYSTEMATIC LITERATURE REVIEW
- Giacomo Cozzi (Italy)
Abstract
Background and Aims
Spondyloarthritis are a group of diseases with a high heritability, whose pathogenesis is strongly determined by an interplay between genetic and environmental factor. Therefore, the aim of our study was to determine whether genetic variants could also influence response to therapy in Spondyloarthritis.
Methods
A systematic literature review (SLR) was conducted in PubMed and Web of Science core collection, without publication-year restrictions. The search strategy was formulated according to the PEO format (Population, Exposure, Outcome) for observational studies. The population was adult patients with Spondyloarthritis. The exposure was inheritable genetic variations of any gene involved in the disease pathogenesis/drug metabolism. The outcome was response to the drug, both as dichotomous (response yes/no) and as continuous outcomes.
Results
393 references were screened by 2 authors, which led to the final inclusion of 26 articles, pertinent with the research question, that were considered for qualitative synthesis. Among these, 10 cohort, 1 cross-sectional and 5 case-control studies were considered of at least good quality. In studies about TNF-blockers therapy: 1) polymorphisms of the TNFRSF1A/1B genes were most frequently able to predict response 2)-238 and -308 polymorphisms of TNFα gene were studied with conflicting results 3) TNFα polymorphism rs1799724, rs1799964, -857, -1013, +489 predicted drug response in non-adjusted analysis 4) PDE3A rs3794271 had a linear relationship with DAS28 reduction after anti-TNFα therapy. DHFR polymorphism +35289 was able to predict response to methotrexate.
Conclusions
Our SLR highlighted the existence of a genetic component in determining drug response. However, further studies are warranted to better define it.
Live Q&A
ENTHESITIS AND ITS RELATIONSHIP WITH DISEASE ACTIVITY, FUNCTIONAL STATUS, AND QUALITY OF LIFE IN PATIENTS WITH PSORIATIC ARTHRITIS
- Lyubov D. Vorobyeva (Russian Federation)
Abstract
Background and Aims
Psoriatic arthritis (PsA) is an infammatory arthritis with distinct phenotypic subtypes. Enthesitis is assigned as a hallmark of the disease, given its signifcant relations to disease activity and patient-reported outcomes (PROs). Our aim is to evaluate the prevalence of enthesitis and its association with some clinical parameters, particularly quality of life (QoL) in PsA patients (pts).
Methods
187 (M/F=97 (50.2%)/90(48.8%) PsA pts fulfilling the CASPAR criteria were included. Mean age 45.6±11.7 years (yrs), DAPSA 21.05±21.03, median (Me) PsA duration 88 [16;421] mo. All pts underwent standard clinical examinations and PROs (EQ-5D, PsAID12, HAQ, BASDAI, FACIT-F) Analysis were performed in 2 groups: enthesitis positive (42.3%) and enthesitis negative (57.7%), for assess enthesitis in PsA pts used Leeds Enthesitis Index (LEI), using parametric and non-parametric tests as appropriate.
Results
When 79 (42.3%) patients with enthesopathy and 108 patients (57.7%) without enthesopathy were compared, patients with enthesitis had more disease activity 40.7±23.3 vs 20.9±18.7 respectively). TJC, SJC, VAS, HAQ, BASDAI, PsAID-12 were signifcantly better in pts without enthesitis (p < 0.05 for all). The comparison of clinical parameters of pts with and without enthesitis is given in Table 1. Moreover, significant but weak positive correlations between the LEI score and TJC, DAPSA, BASDAI, and negative correlations with EQ-5D and FACIT-F were found (p < 0.005 for all) (Table 2).
Conclusions
In PsA pts reported that with enthesitis is associated with greater PsA disease activity and worse functional status and QoL.
Live Q&A
Live Session summary by Chairperson
- Roberta Ramonda (Italy)