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Downloaded from http://ard.bmj.com/ on October 25, 2017 - Published by group.bmj.com
Scientific Abstracts
968
Objectives: To determine the prevalence of classical cardiovascular risk
factors in a series of PsA and determine its association with cardiovascular
events.
Methods: Cross-sectional study of an observational controlled per protocol
cohort in a rheumatology Department of a university hospital, the study
includes an observation period of 20 years (1992-2012). All patients fulfilled
the CASPAR criteria. We included 226 patients who had been visited in 2012.
We analyzed the demographic variables of disease, the variables traditionally
associated with cardiovascular risk (BMI, hypertension, dyslipidemia, DM,
smoking, blood lipid levels) and cardiovascular events recorded (ischemic
heart disease, cerebral vascular accidents, arterial peripheral ischemia).
Statistics: descriptive usual, ANOVA, chi-square, Fisher test, SPSS v.15.
Results: Of the 226 patients studied, 7.5% (17 patients) had had at least
one cardiovascular event. We found a significant association (p <0.05) with
increasing age, male sex, history of DM, dyslipidemia, hypertension and
BMI> 25 (overweight and obesity), as well as higher levels of LDL cholesterol
and triglycerides at the time the study. We found no association with active
smoking, blood pressure, total cholesterol and HDL at the time of the study.
Conclusions: In our series of PsA the presence of classical cardiovascular
risk factors were significantly associated with the prevalence of cardiovascular
events.
Disclosure of Interest: None Declared
AB0583
DOES „MINIMAL DISEASE ACTIVITY“ CORRELATES
WITH COMPOSITE INDICES IN PATIENTS WITH
PSORIATIC ARTHRITIS?
J. Stolfa1, L. Sedova1, Z. Mares1. 1Institute of Rheumatology, Prague, Czech
Republic
Background: Minimal disease activity (MDA) [1] was proposed by EULAR
as an alternative target of treatment of psoriatic arthritis (PsA) pats. in the
absence of remission [2]. MDA comprises 7 items (TJC≤1; SJC≤1; pat. global
assessment VAS score ≤ 2cm; pat.pain VAS score ≤1,5cm; HAQ≤0,5; tender
enthesial points≤1; psoriasis BSA ≤3%). This target has also been incorporated
in the recommendations of Czech Rheumatologic Association. At the same
time we use Disease Activity Index for Psoriatic Arthritis (DAPsA) [3] for the
assessment of the disease activity.
Objectives: We put the question of how MDA correlates with this index
(DAPsA).
Methods: 103 consecutive patients with PsA treated according to standard
algorythm were followed for two to four years (up to 5 controls) and their
clinical activity was assessed using “disease activity index in PsA“(DAPsA)
in four modifications [4]. We retrospectively assessed at each visit if the pats.
reached MDA using 7 items (yes=1/no=0) and the number of items of MDA
they fulfilled (0-7). In total 489 assessment was performed. Enthesitis (13 sites)
was defined merely as a tenderness on palpation, which is a bit equivocal.
Also a quantitative assessment of psoriasis (BSA) by rheumatologist is not too
accurate. So we assessed the achievement of MDA using only 5 items (with
omitting of enthesitis and BSA) in the same patients.
Results: (1) The Pearson correlation coefficient showed to be pretty high
between the increasing number of items of MDA fulfilled and all 4 modifications
of DAPsA (0,961-0,975), as well as the p-value p=(0,01)- tab.1. (2) When using
5-item MDA, the correlation coefficient remained high, and the p-value even
increased (p=0,005).
Tab.1
No. of
items
DAPsA 1
DAPsA 2
DAPsA 3
DAsPA 4
No.of
pats.
0
46,69
43,78
42,33
42,29
10
1
40,88
38,67
35,62
35,67
48
2
30,96
29,07
26,13
26,27
108
3
21,70
20,63
17,78
18,07
74
4
16,34
15,70
13,01
13,20
79
5
12,12
11,83
10,35
10,41
60
6
12,13
11,84
11,03
10,98
58
7
5,08
4,78
4,35
4,15
44
Conclusions: MDA as a therapeutic target of pats.with psoriatic arthritis
closely follows disease activity as assessed by composite measure DAPsA
in all its modifications. Even omitting of enthesitidies and BSA (5-item MDA)
maintains its ability to reflect disease activity. Both modifications of MDA are
suitable as a therapeutic target for the treatment of patients with PsA.
References: 1) Coates LC, Helliwell PS. Validation of minimal disease activity
criteria for psoriatic arthritis using interventional trial data. Arthritis Care Res
(Hoboken) 2010 Jul;62(7):965-9.
2) Gossec L, Smolen JS, Gaujoux-Viala C. European League Against Rheumatism recommendations for the management of psoriatic arthritis with pharmacological therapies. Ann Rheum Dis 2012;71:4-12
3) Schoels M, Aletaha D, Funovits J, Kavanaugh A, Baker D, Smolen JS. Application of the DAREA/DAPSA score for assessment of disease activity in
psoriatic arthritis. Ann Rheum Dis;69(8):1441-7.
Acknowledgements: Supported by the Research program of the Ministry of
health of Czech Republic: IGA MZ CR: No. 000 000 23728
Disclosure of Interest: None Declared
AB0584
SAFETY AND EFFICACY OF ETANERCEPT IN
PATIENTS WITH ACTIVE PSORIATIC ARTHRITIS WITH
PERIPHERAL INVOLVEMENT IN BELGIUM: 66 MONTHS
FOLLOW-UP.
K. de Vlam1, C. Boone2 and Prove Study Group. 1Rheumatology, University
Hospitals Leuven, Leuven, 2Medical Department, Pfizer SA/NV, Brussels,
Belgium
Objectives: to describe the long-term efficacy and types of adverse events
(AEs) in psoriatic arthritis (PsA) patients treated with etanercept in a daily
clinical setting in Belgium.
Methods: This is a prospective, multi-center, open-label, observational study in
patients with active PsA, who have previously failed DMARD therapy. Patients
were treated with etanercept 25 mg subcutaneously twice a week or 50 mg
OW. Health Assessment Questionnaire (HAQ-DI) was completed, swollen joint
count was made, and adverse events (AEs) occurring during the treatment
period were registered. Patients were followed up for 5.5 years.
Results: 303 patients were treated with etanercept, representing a total of
1184 patient-years. 114 patients discontinued treatment, and 33 patients were
lost to follow-up. Reasons for discontinuation included non-responder (primary
and secondary, n =54) and safety (n = 31). 204 (67,77%) patients reported
adverse events of which 177(58,8%) events were related to the treatment.
65(21,59%) patients reported a serious adverse event of which 53 (17,61%)
events are considered to be related to the treatment. Infections were the most
frequent AE’s. 13 cases were considered as serious adverse events.No cases
of tuberculosis were reported. 6 cases of herpes zoster were noticed. Injection
site reactions were uncommon (n=6). Efficacy was evaluated by measuring
number of joints with active synovitis and HAQ-DI. At baseline, the mean
number of joints with active synovitis was 11,81±6,77. At month 6, the mean
number of joints with active synovitis decreased to 2,1 ± 3,36. At month 66,
the mean number of joints with synovitis further decreased to 0,73 ± 2,00. This
represents a statistically significant decrease at both time points from baseline.
118 out of 152 (77,63%) patients with presented with no swollen joints at month
66. At baseline, the mean HAQ-DI-score (/60) was 26,99±8,94. At month 6, the
mean HAQ- DI score decreased to 9,72± 9,37. At month 66, the HAQ-DI-score
was 7,70± 9,09. This represents a statistically significant decrease at both time
points from baseline.
Table 1: Patient characteristics and safety outcomes
Age (mean +/- SD)
48,29 +/- 10,83
Gender (male%)
54,79
Disease Duration (mean+/- SD)
7,5 +/- 7,4
Exposure to ETC (mean +/- SD)
3,93 +/-1,86
Exposure to MTX (mean +/- SD)
4,41 +/- 4,19
Total PY
1184
AE, rate/100PY
112,19
Infections, rate/100PY
26,19
SAE, rate/100PY
10,05
Serious Infections, rate/100PY
1,36
Injection site reactions, rate/100PY
0,84
Neoplasms, rate/100 PY
0.94
Conclusions: These results confirm the safety and efficacy profile of Enbrel in
psoriatic arthritis when used in daily clinical practice in Belgium. No new safety
signals were detected.
Disclosure of Interest: K. de Vlam Consultant for: Pfizer, Speakers bureau:
Pfizer, C. Boone Employee of: Pfizer
AB0585
HIGH PREVALENCE OF PSORIATIC ARTHRITIS IN THE
MIDDLE OF NORWAY
M. Hoff1,2, A. Kavanaugh 3, P. Romundstad2, A. M. Gulati1, G. Haugeberg4,5.
1
Rheumatology, St. Olavs Hospital, 2Public Health and General Practice,
NTNU, Trondheim, Norway, 3Rheumatology, Allergy, Immunology, UC,
San Diego, United States, 4Rheumatology, Hospital of Southern Norway,
Kristiansand, 5Neuroscience, NTNU, Trondheim, Norway
Background: Studies indicate that the prevalence of psoriatic arthritis (PsA)
range from 0.02-0.25 % in various parts of the world [1]
Objectives: To explore the prevalence of PsA based on the Norwegian
population survey “Helse undersøkelsen i Nord Trøndelag” (HUNT-3)
performed in 2006-08.
Methods: In HUNT 3 an invitation letter was mailed to all 94,194 adult
inhabitants (aged > 20 yrs) in the county Nord-Trøndelag. A total of 50,806
(54%) responded and answered a questionnaire (Q1) and underwent a brief
medical examination. Q1 included questions if patients suffered from psoriasis,
rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Patients answering
Downloaded from http://ard.bmj.com/ on October 25, 2017 - Published by group.bmj.com
AB0583 Does ?minimal disease activity''
correlates with composite indices in patients
with psoriatic arthritis?
J. Stolfa, L. Sedova and Z. Mares
Ann Rheum Dis 2013 72: A968
doi: 10.1136/annrheumdis-2013-eular.2905
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