P3407Genetic predisposition and QRISK3 algorithm are promising cardiovascular risk scoring tools in young patients with axial spondyloarthritis (Bechterew's disease)

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Vasilenko ◽  
A Dadalova ◽  
O Nikolaeva ◽  
M Korolev ◽  
V Mazurov ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Gene Polymorphisms ◽  
Axial Spondyloarthritis ◽  
Young Patients ◽  
Inactive Disease ◽  
Major Cardiovascular Events ◽  
Asas Criteria ◽  
Tnf Α ◽  
Risk Scoring ◽  
Similar Gene

Abstract Introduction Major cardiovascular events (CVE) are frequently registered in patients with axial spondyloarthritis (axSpA) at age 35–55 years old. However, assessment of cardiovascular risk (CVR) in these age is complicated, as in pts <40 years conventional CVR scales (SCORE, ets.) are not recommended. Aim of the study To show capability of QRISK3 in assessment of CVR in young pts with axSpA and its association with gene polymorphisms, responsible for the inflammation and neoangiogenesis. Materials and methods The study included 46 pts 25–40 years old with axSpA (ASAS criteria 2009), achieved inactive disease on TNF-α inhibitors. AxSpA activity was assessed with ASDAS and BASDAI, CVR with QRISK3 (https://qrisk.org/three/). Gene polymorphisms to cytokines, responsible for inflammation and neoangiogenesis were measured (IL17A-197, IL17F7 His/Arg, IL17F-11139 c/g, TNF-863, TNF-308, TNF-238, IL1B-31, IL4–590, IL6–174, IL10–1082, IL10–592, VEGF-2578, VEGF936, MMP2–1306, MMP3–5A6A, and MMP9–1562). Results Mean age of axSpA pts was 32.5±3.87 years, 36 (78.3%) pts were male, axSpA duration 8.71±4.72 years, duration of the treatment 3.1±2.4 years, ASDAS 1.95±1.23, BASDAI 1.4±0.8, QRISK3 score 1.18±1.64%. 34 (75.6%) of the pts had a low CVR and 11 (23.9%) had increased CVR. All the patients with increased CVR had strong associations with some alleles of TNFα, IL17F and IL6, p<0.ehz745.0282 for all the correlations (table 1). Interrelations of CVR with another gene polymorphisms were not significant (R<0.25, p≥0.05, data are not present). Coefficient of correlation of QRISK3 and Gene polymorphisms (results of exploratory factor analysis with “varimax” rotation) QRISK3 IL17F-11139 CC IL17F-11139 CG IL17F7 His/His IL17F7 His/Arg IL6–174 CC IL6–174 CG TNF-308 GA TNF-308 GG 0.486 0.830 −0.830 −0.824 0.809 −0.564 0.545 0.935 −0.935 Conclusion A quarter of axSpA pts in age <40 years have an increased CVR. Similar gene polymorphisms in IL-6, IL17F, and TNF-α are strongly associated with increased CVR. QRISK3 and gene polymorphisms could be promising tools in CVR assessment in axSpA, acceptable in any age. Conflict of interests Not declared.

scholarly journals Predictors of Loss of Remission and Disease Flares in Patients with Axial Spondyloarthritis Receiving Antitumor Necrosis Factor Treatment: A Retrospective Study

2016 ◽  
Vol 43 (8) ◽  
pp. 1541-1546 ◽  
Author(s):  
Ennio Lubrano ◽  
Fabio Massimo Perrotta ◽  
Maria Manara ◽  
Salvatore D’Angelo ◽  
Olga Addimanda ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Residual Disease ◽  
Activity Index ◽  
Inactive Disease ◽  
Disease Flare ◽  
Asas Criteria ◽  
Disease Reactivation ◽  
Necrosis Factor

Objective.The aim of this study was to evaluate rate and predictive factors of loss of remission and disease flare in patients with axial spondyloarthritis (axSpA) receiving antitumor necrosis factor (anti-TNF) treatment.Methods.In this retrospective multicenter study, patients with axSpA, according to the Assessment of Spondyloarthritis international Society (ASAS) criteria, treated with adalimumab, etanercept, or infliximab with a minimum followup of 12 months and satisfying the ASAS partial remission criteria and/or Ankylosing Spondylitis Disease Activity Score (ASDAS) inactive disease were studied. Disease flare was defined as a Bath Ankylosing Spondylitis Disease Activity Index score > 4.5 or ASDAS score > 2.5 on at least 1 occasion.Results.One hundred seventy-four patients with axSpA were studied. After a median [interquartile range (IQR)] followup of 4 years (2–6), 37 patients (21.2%) experienced a loss of remission and 28 (16.1% of the whole study group) a disease flare. Median (IQR) duration of remission in patients who lost this status was 1 year (0.625–2). Higher median erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values, continuous nonsteroidal antiinflammatory drug (NSAID) use, and an ASDAS-CRP ≥ 0.8 during the remission period were significantly associated with both loss of remission and disease flare. At the multivariate analysis, continuous NSAID intake (OR 4.05, 95% CI 1.4–11.74, p = 0.010) and ESR > 15 (OR 2.90, 95% CI 1.23–6.82, p = 0.015) were the only factors predictive of disease reactivation.Conclusion.In this study, loss of remission and disease flares occurred, respectively, in about 21% and 16% of the patients with axSpA who achieved a state of remission while receiving anti-TNF therapy. Residual disease activity was associated with disease reactivation.

Disease activity trajectories in early axial spondyloarthritis: results from the DESIR cohort

2016 ◽  
Vol 76 (6) ◽  
pp. 1036-1041 ◽  
Author(s):  
Anna Molto ◽  
Sophie Tezenas du Montcel ◽  
Daniel Wendling ◽  
Maxime Dougados ◽  
Antoine Vanier ◽  
...  
Keyword(s):  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
High Disease Activity ◽  
Inactive Disease ◽  
Joint Involvement ◽  
Asas Criteria ◽  
Very High ◽  
Trajectory Modelling ◽  
Over Time

BackgroundDisease activity may change over time in axial spondyloarthritis (axSpA). The objectives were to identify patterns of disease activity evolution in patients with early axSpA.MethodsPatients from the prospective early axSpA cohort (DEvenir des Spondyloarthrites Indifférenciées Récentes (DESIR)) who fulfilled the Assessment in SpondyloArthritis Society (ASAS) criteria for axSpA at baseline and with at least three Ankylosing Spondylitis Disease Activity Score (ASDAS) values available over the 3 years of follow-up were analysed. Statistical analyses: trajectories were estimated by group-based trajectory modelling; predisposing baseline factors for such trajectories were identified by univariate and multivariable multinomial (logit) regression; work disability over time was compared between the trajectories by Cox hazard model.ResultsIn all, 370 patients were analysed: mean disease duration was 1.6 (±0.9) years. The five distinct trajectories of disease activity over the 3 years were (t1) ‘persistent moderate disease activity’ (n=134 (36.2%)); (t2) ‘persistent inactive disease’ (n=66 (17.8%); (t3) ‘changing from very high disease activity to inactive disease’ ((n=29 (7.8%)); (t4) ‘persistent high disease activity’ (n=126 (34.1%)) and (t5) ‘persistent very high disease activity’ (n=15 (4.1%)). After adjustment for other characteristics, t2 was associated with a white-collar job (OR=2.6 (95% CI 1.0 to 6.7)) and t3 with male gender (OR=7.1 (1.6 to 32.2)), higher education level (OR=9.4 (1.4 to 63.4)) and peripheral joint involvement (OR=6.2 (1.23 to 31.32)). Patients from (t4) and (t5) were more often declared work disabled over follow-up (HR=5.2 (1.5 to 18.0) and HR=8.0 (1.3 to 47.9), respectively).ConclusionsTrajectory modelling of disease activity was feasible in early axSpA: more than 30% patients (141/370) were in a trajectory with a persistent high disease activity. Persistent high disease activity trajectories were significantly associated with consequences on work.Trial registration numberNCT01648907.

scholarly journals SAT0393 DISCREPANCY IN THE CARDIOVASCULAR RISK SEVERITY CALCULATED USING DIFFERENT RATING SCALES IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1145.2-1146
Author(s):  
E. Vasilenko ◽  
V. Mazurov ◽  
R. Samigullina ◽  
A. Dadalova ◽  
I. Gaydukova
Keyword(s):  
Cardiovascular Risk ◽  
Risk Evaluation ◽  
Rating Scales ◽  
Axial Spondyloarthritis ◽  
Inflammatory Diseases ◽  
Mean Value ◽  
Risk Algorithm ◽  
Asas Criteria ◽  
Score Index ◽  
Reynolds Risk Score

Background:Cardiovascular risk (CVR) in patients (pts) with axial spondyloarthritis (axSpA) exceed the populational level. However, it remains unclear, which of the cardiovascular risk assessment systems is the most accurate in cases of chronic inflammation..Objectives:of the current study were to assess the CVR in pts with axSpA and to compare different cardiovascular risk scales in these pts.Methods:The study included 118 patients at the age of 25-65 years with diagnosis of axSpA fulfilling ASAS criteria (2009) from St. Petersburg’ axSpA register. Three indices of cardiovascular risk evaluation (Systematic COronary Risk Evaluation (SCORE) with increasing coefficient 1.5 for inflammatory diseases, Reynolds Risk Score (RRS), and the third modification of QRESEARCH Cardiovascular Risk Algorithm (QRISK3) were calculated. For the pts below 40 years old only QRISK3 was calculated.Results:Mean age of the pts was 44.3±11.1 years; 91(77.1%) pts were males, HLA-B27 positive – 83 (70.3%) of the pts; mean disease duration 13.0±8.3 years. Mean value of SCORE was 2.78±1.89%, of RRS – 5.28±3.31%, of QRISK3 – 7.91±3.8% (figure 1). Cronbach’s alpha for the scales was 0.873.Figure 1.Cardiovascular risk evaluation indices in patients with axial spondyloarthritis, n=118 for QRISK3, n=72 for SCORE and RRS.High CVR (≥5 %) was found in 14 (11,7%) of the pts according to the SCORE, in 65 (55,1%) of the pts according to the RRS, and in 81 (69%) of the pts according to the QRISK3. Ranking of CVR severity did not match in SCORE and QRISK3 indices in 83.72% of cases, in SCORE and RRS – in 51.16% of cases, and in QRISK3 and RRS in 8% of cases. The SCORE index showed the lower values of the expected risk as compared to the QRISK3 and RRS (figure1).In axSpA pts at age 25-40 years old (n=46, mean age 32.6±4.0 years, males 36 (78.3%)), mean value of QRISK3 was 1.16±0.99 %; in 14 from 46 (30.4%) of those pts increased CVR was registered (figure 2).Figure 2.QRISK3 index in axSpA patients 25-40 years old, n=46Conclusion:There was a discrepancy in the severity of CVR calculated using different rating scales in axSpA patients. The SCORE index showed lower values of CVR as compared to the QRISK3 and RRS, which hypothetically could be the consequence of CVR underestimation. QRISK3 demonstrated the highest CVR and was the only index useful in pts below 40 years old. To exclude hyper- or underestimation of CVR calculation more data about CVR calculations and frequency of CV events, occurring in axSpA patients are needed.Disclosure of Interests:Elizaveta Vasilenko: None declared, V Mazurov: None declared, Ruzana Samigullina: None declared, Anna Dadalova: None declared, Inna Gaydukova Grant/research support from: JSC BIOCAD, Speakers bureau: Pfizer, Novartis, AbbVie, JSC BIOCAD, Сelgene, MSD, Sanofi

scholarly journals POS1019 INCONSISTENCY OF THE DEGREE OF CARDIOVASCULAR RISK WHEN ASSESSED USING DIFFERENT INDICES IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 777.1-777
Author(s):  
E. Vasilenko ◽  
A. Dadalova ◽  
R. Samigullina ◽  
V. Mazurov
Keyword(s):  
Cardiovascular Risk ◽  
Risk Evaluation ◽  
Axial Spondyloarthritis ◽  
Inflammatory Diseases ◽  
Mean Value ◽  
Low Risk ◽  
Assessment Index ◽  
Risk Algorithm ◽  
Asas Criteria ◽  
Very High

Background:Evaluation of indicators of cardiovascular risk is one of the main tasks facing a rheumatologist in the tactics of choosing a therapy for patients (pts) with axial spondyloarthritis (axSpA). It is known that pts suffering from axSpA are characterized by a significant increase in cardiovascular risk (CVR). However, there are still no recommendations regulating risk assessment scales in pts with axSpA.Objectives:were to assess the CVR in pts with axSpA and to compare different cardiovascular risk scales in these pts.Methods:The study included 55 pts at the age of 45-65 years with diagnosis of axSpA fulfilling ASAS criteria (2009) from St. Petersburg’ axSpA register. Three indices of cardiovascular risk evaluation (Systematic COronary Risk Evaluation (SCORE) with increasing coefficient 1.5 for inflammatory diseases, Reynolds Risk Score (RRS), and the third modification of QRESEARCH Cardiovascular Risk Algorithm (QRISK3) were calculated. Risk gradation: low risk (<1%), medium (1.0-4.9%), high (5.0-9.9%), very high (> 10%).Results:Mean age of the pts was 45.8±10.3 years; males - 37 (67.3%) pts, HLA-B27 positive – 34 (61.8%); mean disease duration 12.5±8.7 years. Mean value of SCORE was 2.83±1.89%, of RRS – 5.04±3.98%, of QRISK3 – 7.91±4.91%.The gradation of the degree of risk depending on the applied assessment index is presented in Table 1.IndexResultsRisk degreeSCORERRSQRISK3Low21 (38,2%)8 (14,5%)0 (0,0%)Medium26 (47,3%)23 (41,8%)17 (30,9%)High8 (14,5%)17 (30,9%)22 (40,0%)Very high0 (0,0%)7 (12,7%)16 (29,1%)Particular attention is drawn to the 100% discrepancy of low risk values when comparing SCORE and QRISK3. A similar trend persisted when comparing medium, high and very high risk. Thus, the assessment of the risks of 10-year significant cardiovascular events in pts with axSpA using the SCORE index does not coincide with the QRISK3 index data in 87.27% of cases, and with the RRS data - in 58.18% of cases. In 84.3% of cases, the mismatch between the SCORE and RRS indexes was due to the presence of an increased CRP level.Conclusion:When assessing cardiovascular risk in pts with axial spondyloarthritis, a discrepancy was found between the degrees of risk when assessed using different scales. SCORE scores were significantly different from Reynolds’ and QRISK3 scores. These features can be interrelated with a small number of factors assessed when calculating the SCORE, even though there is a correction factor for rheumatic diseases. For pts with axial spondyloarthritis, it is necessary to use additional indicators that influence cardiovascular risk, such as CRP.Disclosure of Interests:None declared.

Treatment response and drug retention rates in 24 195 biologic-naïve patients with axial spondyloarthritis initiating TNFi treatment: routine care data from 12 registries in the EuroSpA collaboration

2019 ◽  
Vol 78 (11) ◽  
pp. 1536-1544 ◽  
Author(s):  
Lykke Midtbøll Ørnbjerg ◽  
Cecilie Heegaard Brahe ◽  
Johan Askling ◽  
Adrian Ciurea ◽  
Herman Mann ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Retention Rate ◽  
Response Rates ◽  
Routine Care ◽  
Retention Rates ◽  
Inactive Disease ◽  
Drug Retention ◽  
Asas Criteria

ObjectiveTo study drug retention and response rates in patients with axial spondyloarthritis (axSpA) initiating a first tumour necrosis factor inhibitor (TNFi).MethodsData from 12 European registries, prospectively collected in routine care, were pooled. TNFi retention rates (Kaplan-Meier statistics), Ankylosing Spondylitis Disease Activity Score (ASDAS) Inactive disease (<1.3), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) <40 mm and Assessment of SpondyloArthritis International Society responses (ASAS 20/40) were assessed at 6, 12 and 24 months.ResultsA first TNFi was initiated in 24 195 axSpA patients. Heterogeneity of baseline characteristics between registries was observed. Twelve-month retention was 80% (95% CI 79% to 80%), ranging from 71% to 94% across registries. At 6 months, ASDAS Inactive disease/BASDAI<40 rates were 33%/72% (LUNDEX-adjusted: 27%/59%), ASAS 20/40 response rates 64%/49% (LUNDEX-adjusted 52%/40%). In patients initiating first TNFi after 2009, 6097 patients was registered to fulfil ASAS criteria for axSpA, 2935 was registered to fulfil modified New York Criteria for Ankylosing Spondylitis and 1178 patients was registered as having non-radiographic axSpA. In nr-axSpA patients, we observed lower 12-month retention rates (73% (70%–76%)) and lower 6-month LUNDEX adjusted response rates (ASDAS Inactive disease/BASDAI40 20%/50%, ASAS 20/40 45%/33%). For patients initiating first TNFi after 2014, 12-month retention rate, but not 6-month response rate, was numerically higher compared with patients initiating TNFi in 2009–2014.ConclusionA large European database of patients with axSpA initiating a first TNFi treatment in routine care, demonstrated that 27% of patients achieved ASDAS inactive disease after 6 months, while 59% achieved BASDAI <40. Four of five patients continued treatment after 1 year.

Association of plaque echostructure and cardiovascular risk factors with symptomatic carotid artery disease

VASA ◽  
2009 ◽  
Vol 38 (4) ◽  
pp. 357-364 ◽  
Author(s):  
Giannoukas ◽  
Sfyroeras ◽  
Griffin ◽  
Saleptsis ◽  
Antoniou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Cardiovascular Risk Factors ◽  
Carotid Plaque ◽  
Young Patients ◽  
Symptomatic Disease ◽  
Age Related ◽  
Ica Stenosis

Background: Severity of stenosis remains the main factor for assessing risk of stroke in patients with internal carotid artery (ICA) disease. This study was conducted to investigate the association of plaque echostructure and other established and emerging cardiovascular risk factors with symptomatic ICA disease. Design: Cross-sectional study of consecutive patients with significant (> 50 %) ICA stenosis. Patients and methods: Carotid plaque echostructure, smoking, hypertension, diabetes mellitus, serum lipoprotein (a), homocysteine, vitamin B12, folate, cholesterol to high-density lipoprotein ratio, triglycerides, C-reactive protein, and the Framingham risk score were assessed in 124 consecutive patients (70 asymptomatic; 54 symptomatic) with significant (> 50 %) ICA stenosis. Results: The asymptomatic and symptomatic groups did not differ in terms of gender distribution (p = 0.76) and severity of stenosis (p = 0.62). Echolucent plaques (type 1 and 2) were more predominant in patients with symptomatic disease (p = 0.004, OR = 2.13, 95 % CI = 1.26-3.6). Patients with plaques type 1 were relatively younger than those with type 4 (p = 0.02). None of the other factors assessed had any significant association with symptomatic disease and any type of carotid plaque. Conclusions: Besides the severity of carotid stenosis, the presence of an echolucent plaque appears as an important factor associated with symptomatic ICA disease. Also, young patients are more likely to have an echolucent plaque suggesting an age-related association with plaque maturation.

Comparison of Non-radiographic Axial Spondyloarthritis and Ankylosing Spondyltis from a Single Rheumatology Hospital in Morocco

2020 ◽  
Vol 16 (3) ◽  
pp. 240-244 ◽  
Author(s):  
Nessrine Akasbi ◽  
Siar Nihad ◽  
Zoukal Sofia ◽  
El Kohen Khadija ◽  
Harzy Taoufik
Keyword(s):  
Disease Burden ◽  
Axial Spondyloarthritis ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Low Back ◽  
New Classification ◽  
Cross Sectional ◽  
Asas Criteria ◽  
History Of ◽  
High Level

Background: According to the new classification criteria developed by The Assessment of SpondyloArthritis International Society, patients with axial spondyloarthritis (axSpA) can be classified in 2 subgroups: Patients with radiographic axial spondyloarthritis: ankylosing spondylitis patients (AS) and those with non-radiographic axial spondyloarthritis (nr-axSpA). Objective: The aim of the present study is to describe and discuss the differences and similarities between the two subgroups. Patients and Methods: A cross-sectional study was conducted in a single rheumatology hospital in Morocco. These included patients diagnosed as having axial spondyloarthritis according to ASAS criteria 2010, during a period of 6 years. The AS and the nr-axSpA subgroups were compared for the various axSpA-related variables. Results: Of the 277 patients with a diagnosis of axial SpA who were included in this study, 160 had AS and 117 had nr-axSpA. AS and nr-ax-SpA shared a similar age at diagnosis, similar prevalence of low back pain, lumbar stiffness, extra-articular manifestations, BASDAI and BASFI. In the multivariate analysis, AS patients were mainly male with cervical stiffness, enthesitis, coxitis and high level of ESR (erythrocyte sedimentation rate). The females generally had a family history of SpA and arthritis and were associated to the nr-axSpA form in the univariate analysis. Conclusion: This was the first study to characterise patients with AS and nr-axSpA in Morocco. Consistent with other studies published, this study showed that patients with nr-axSpA and patients with AS shared a comparable degree of disease burden.

scholarly journals SAT0380 ENHANCING RHEUMATOLOGY REFERRALS AMONG INFLAMMATORY BOWEL DISEASE PATIENTS WITH SUSPECTED AXIAL SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1138.2-1138
Author(s):  
C. S. E. Lim ◽  
M. Tremelling ◽  
L. Hamilton ◽  
A. Macgregor ◽  
K. Gaffney
Keyword(s):  
Back Pain ◽  
Musculoskeletal Pain ◽  
Chronic Back Pain ◽  
Axial Spondyloarthritis ◽  
Inflammatory Back Pain ◽  
Aminosalicylic Acid ◽  
Research Support ◽  
Clinical Probability ◽  
Asas Criteria ◽  
History Of

Background:Axial spondyloarthritis (axSpA) is associated with inflammatory bowel disease (IBD). In IBD patients, the clinical probability of axSpA increases in those with chronic back pain (CBP) whose symptoms started before the age of forty-five years old. In practice, this should trigger a rheumatology review especially if accompanied by other symptoms suspicious of inflammatory disease. However, in any health system, the goal of identifying all possible cases need to be balanced with the practical realisation of the finite resources available.Objectives:The study aimed to define the clinical characteristics of a subgroup of IBD patients who are routinely managed in secondary care who have an increased clinical probability for axSpA. Identification of these characteristics may help improve the quality and specificity of referrals to Rheumatology from Gastroenterology clinics.Methods:An analytical cross-sectional study was undertaken. Consecutive IBD patients attending routine Gastroenterology clinics were sent a modified validated back pain questionnaire. The questionnaire included the presence or absence of a previous diagnosis of axSpA; components of validated inflammatory back pain criteria; diagrams to indicate the location of back pain and other musculoskeletal pain; personal and family history of known axSpA manifestations; and details of their IBD course, activity and treatment.IBD patients, with back pain duration > 3 months with onset before 45 years were considered to have a medium diagnostic probability (MDP) for axSpA. MDP-positive IBD patients were compared with MDP-negative IBD patients and logistic regression was used to model the association with clinical features.Results:Four hundred and seventy consecutive IBD patients (mean age 54 years; 46% male) were surveyed. Two hundred and nine patients (59%) replied, of whom 191 patients (69%) consented to participate. One hundred and seventy-three (91%) of those who consented had a valid completed questionnaire and were included for data analysis. Of these, 74% had Ulcerative Colitis and 26% had Crohn’s disease. Their mean age was 58 years, 39% male. Mean age at IBD diagnosis was 39 years, mean IBD disease duration 19 yrs. CBP (back pain greater than three months) was reported by 76%. Inflammatory back pain fulfilling Calin, Berlin, ASAS criteria was seen in 23%, 29%, and 15% respectively. In addition, 80% reported peripheral musculoskeletal pain. Self-reported personal history of enthesitis, reactive arthritis (ReA), acute anterior uveitis (AAU), skin psoriasis (PSO) and dactylitis were 50%, 30%, 24%, 15% and 0% respectively. Self-reported family history of IBD, ReA, PSO, axSpA and AAU were 60%, 36%, 22%, 11%, and 1% respectively.Ninety-one (53%) patients were MDP-positive and 82 (47%) patients were MDP-negative. The clinical characteristics associated with MDP (adjusted for age at invitation) were: the presence of inflammatory back pain using ASAS criteria [OR 8.84 (1.61,48.67); p=0.01], longer interval between symptom onset and gastroenterologist diagnosis of IBD [OR 1.09 (1.03,1.16); p=0.005], and use of rectal topical 5-aminosalicylic acid [OR 3.27 (1.11,9.68); p=0.03].Conclusion:Chronic back pain and peripheral musculoskeletal pain are common in a secondary care IBD population. In IBD patients, with back pain duration > 3 months and onset before 45 years, the presence of inflammatory back pain, longer diagnostic delay of IBD and the use of rectal topical 5-aminosalicylic acid were associated with a higher clinical probability of axSpA. The identification of these clinical features may not only improve the quality and specificity of Rheumatology referrals from Gastroenterology in this subgroup of patients but also lends real world evidence to current ASAS-endorsed recommendations for early referral of patients with a suspicion of axial spondyloarthritis.Disclosure of Interests:Chong Seng Edwin Lim Grant/research support from: AbbVie - Research support/grant but NOT for this study., Mark Tremelling: None declared, Louise Hamilton: None declared, Alexander Macgregor: None declared, Karl Gaffney Grant/research support from: AbbVie, Celgene, MSD, Novartis, Pfizer, and UCB Pharma, Consultant of: AbbVie, Celgene, MSD, Novartis, Pfizer, and UCB Pharma, Speakers bureau: AbbVie, Celgene, MSD, Novartis, Pfizer, and UCB Pharma

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