Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Anti-TNF Efficacy Against Spondyloarthropathy without Associated Imaging Signs.
Bisson-Vaivre1, Aurélia, Menard1, Jean-François, Alcaix2, Didier, Vittecoq1, Olivier, Le Loet1, Xavier X., Zarnitsky2, Charles, Goeb1, Vincent
Some clinical presentations satisfy spondyloarthropathy (SpA)-diagnosis criteria without any detected imaging signs, sometimes posing the question of when early biotherapy should be started. Objective: To evaluate anti-TNFa efficacy in patients with clinical but not imaging (radiographic, computed-tomography scan, MRI) signs of SpA.
This retrospective study concerned patients with axial SpA followed in 2 hospitals, treated, according to EULAR recommendations, with anti-TNFa after failure of conventional therapies. Therapeutic responses, assessed according to BASDAI50 and ASAS20 or -40 definitions, were evaluated after 6 and 12 months. Factors associated with those responses were also sought.
Among 385 patients included, 257 with imaging signs had significantly more frequent therapeutic responses and partial remissions (p=0.0005 and 0.03, respectively). The response rate of HLA-B27 carriers with initial imaging sign(s) was significantly higher (p=0.028). Responders were younger at biotherapy onset, with lower BASFI and pain visual analog scale score, and higher CRP, compared to nonresponders. About 40% of the SpA patients without imaging sign(s) responded to anti-TNFa.
The initial presence of SpA imaging sign(s) seems to be a factor prognostic of the response to anti-TNFa, especially in HLA-B27 carriers. However, the percentage of patients with exclusively clinical SpA signs and responding to anti-TNFa was far from negligible, thereby reinforcing the pertinence of ASAS criteria.
To cite this abstract, please use the following information:
Bisson-Vaivre, Aurélia, Menard, Jean-François, Alcaix, Didier, Vittecoq, Olivier, Le Loet, Xavier X., Zarnitsky, Charles, et al; Anti-TNF Efficacy Against Spondyloarthropathy without Associated Imaging Signs. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1302