TRATAMIENTO ESPONDILOARTRITIS

JESÚS SANZ SANZ

SOBRE LO QUE TENEMOS

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BENEFICIAL LONG-TERM EFFECT OF A SUPERVISED EXERCISE PROGRAM ON PHYSICAL ACTIVITY LEVEL IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: 12 MONTHS FOLLOW-UP OF A MULTICENTER RANDOMIZED CONTROLLED TRIALSilje Halvorsen Sveaas1, Hanne Solveig Dagfinrud1, Melissa Woll Johansen2, Elisabeth Pedersen3, Annelie Bilberg4

Exercise group(n=43) Control group (n=44)

Age, years, mean (min-max)

45.5 (23-68) 47.4 (24-69)

Sex, male, n (%) 22 (51%) 20 (46%)

Radiographic axSpA 32 (74%) 28 (64%)

TNF-inhibitor, n (%) 38 (44%) 20 (46%)

ASDAS, mean (SD) 2.6 (0.7) 2.5 (0.7)

A three month supervised exercise program delivered by physiotherapists had a significant long-term beneficial effect on PA-level in patients with axSpA.

GOLIMUMAB PERSISTENCE IN BIOLOGIC NAÏVE AND NON-NAÏVE PATIENTS WITH AXIAL SPONDYLOARTHRITIS: RESULTS OF THE GO-PRACTICE STUDYPhilippe Bertin, Philippe Goupille, Florence Tubach, Jean Ouaniche, Eric Lespessailles, Najat Gouyette, Naoual Harid, Jean-Marie Fayette, Bruno Fautrel, René-Marc Flipo

BN patients

BP patients

BL 2 years BL 2 years P*

ASDAS-CRP, Mean (SD)

3.2(0.8) 1.5(0.9) 3.1(0.8) 2.0(1.0) P = .0051

BASDAI, Mean (SD)

5.3(1.7) 2.6(1.9) 5.7(1.6) 3.1(2.0) P <.0001

Disease activity at BL and 2 years for BN and BP patients with aS persistingon GLM

BN (n=291) and 39% (n=187)

EARLIER TREATMENT OF NON-RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS WITH CERTOLIZUMAB PEGOL RESULTS IN IMPROVED CLINICAL OUTCOMESMartin Rudwaleit, Lianne S. Gensler, Atul Deodhar, Jonathan Kay, Walter P. Maksymowych, Nigil Haroon, Robert B.M. Landewé, Simone Auteri, Natasha de Peyrecave, Thomas Kumke, Désirée van der Heijde

SECUKINUMAB PROVIDED SIMILAR EFFICACY IN MALES AND FEMALES WITH ACTIVE ANKYLOSING SPONDYLITIS OVER 52 WEEKS: POST HOC POOLED ANALYSIS OF THE MEASURE TRIALSIrene van der Horst-Bruinsma, Corinne Miceli Richard, Juergen Braun, Weibin Bao, Brian Porter, Effie Pournara

SIMILAR ONE-YEAR TREATMENT RETENTION OF ORIGINATOR AND BIOSIMILAR ETANERCEPT. RESULTS OF A NORDIC COLLABORATION INCLUDING 1015 PATIENTS WITH SPONDYLOARTHRITIS.

Bente Glintborg, Ulf Lindström, Daniela DI Giuseppe, Johan Askling, Dan Nordström, Sella Aarrestad Provan, Björn Gudbjornsson, Merete L. Hetland, Kalle Aaltonen, Arni Jon Geirsson, Niels Steen Krogh, Lennart T.H. Jacobsson

ASAS 40 SEM 12

NETAKIMAB (anti-IL17A) REDUCES THE DISEASE ACTIVITY OF RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS. RESULTS OF ASTERA STUDY.

Inna Gaydukova1, V Mazurov1, Shandor Erdes2, Tatiana Dubinina2, Olga Nesmeyanova3, Elena Ilivanova4, Alena Kundzer5, Nikolaj Soroka6, Aleksander Kastanayan7, Tatyana Povarova8, Elena Zhugrova9, Tatyana Plaksina10, Pavel Shesternya11, Tatyana Kropotina12, Olga Antipova13, Elena Smolyarchuk14, Oksana Tciupa15, Diana Abdulganieva16, Diana Kretchikova17, Ivan Gordeev18, Vadim Tyrenko19, Aleksandra Strelkova20, Anna Eremeeva21, Ekaterina Chernyaeva21, Roman Ivanov2

ARTICULAR MANIFESTATIONS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE TREATED WITH VEDOLIZUMABAnastasia Dupré1, Michael Collins1, Franck Carbonnel1, Xavier Mariette1, Gaetane Nocturne1, Raphaèle Seror1

Manifestaciones articulares hay en 30% de tratados con VEDOLIZUMAB. La mitad de ellos (15%) fueron inflamatorios, incluyendo 5% con artralgia reversible durante la infusion. 11 manifestaciones ligadas a IBD ( 7 espondiloartritispotencialmente enmascaradas por tto previo anti-TNFα. El único factor predictivo de artritis inflamatoria fue la historia previa de artritis. La suspensión de VEDOLIZUMAB por este motivo fue solo en 1 paciente.

IXEKIZUMAB IMPROVES SIGNS AND SYMPTOMS OF PSORIATIC ARTHRITIS IN PATIENTS WHO HAVE HAD INADEQUATE RESPONSE TO 1 OR 2 TUMOR NECROSIS FACTOR INHIBITORSL Bruce Kirkham1, Carlos Sesin2, Aubrey Trevelin Sprabery3, Chen-Yen Lin3, Amanda M. Gellett3, Anthony Turkiewicz4

IXEKIZUMAB IMPROVES SIGNS AND SYMPTOMS OF PSORIATIC ARTHRITIS IN PATIENTS WHO HAVE HAD INADEQUATE RESPONSE TO 1 OR 2 TUMOR NECROSIS FACTOR INHIBITORSL Bruce Kirkham1, Carlos Sesin2, Aubrey Trevelin Sprabery3, Chen-Yen Lin3, Amanda M. Gellett3, Anthony Turkiewicz4

EFFECT OF BIOLOGICS ON ENTHESITIS AND DACTYLITIS IN PATIENTS WITH psoriatic arthritis: A SYSTEMATIC REVIEW AND META-ANALYSIS,WU Dongze, Priscilla C. Wong, James F. Griffith, Lai-Shan Tam

19 estudios (8,208 pacientes), 10 fármacos (adalimumab, infliximab, certolizumab pegol, golimumab, secukinumab, ustekinumab, ixekizumab, abatacept, tofacitinib and apremilast

Los biológicos son eficaces para PsA con entesitis y dactilitis.

IL-blocker son probablemente una mejor opción a considerar enpacientes con predominio de entesitis y dactilitis.

EFFECTIVENESS OF BIOLOGIC DRUGS WITH DIFFERENT MECHANISM OF ACTION IN PSORIATIC ARTHRITIS. AN APPRAISAL FROM THE APULIAN REGISTRY BIOPURENicola Maruotti, Giorgio Carlino, Leonardo Santo, Laura Quarta, Romano Bucci, Carmelo Zuccaro, Angelo Semeraro, Antonio Marsico, Daniela Mazzotta, Paola Chiara Francesca Falappone, Florenzo Iannone

Se alcanza una buena tasa de DAPSA remisión con todos los tratamientos en práctica clínica real.

Predictores de remisión y persistencia de tto son: varones y naïve a previo bDMARDs.

No se encuentran diferencias entre ttos.

450 PsA ( 60% female)

PROBABILITY OF ACHIEVING LOW DISEASE ACTIVITY OR REMISSION IN SUBJECTS WITH ACTIVE PSORIATIC ARTHRITIS TREATED WITH APREMILASTPhilip J. Mease, Frank Behrens, Dafna D. Gladman, Arthur Kavanaugh, Michele Brunori, Lichen Teng, Benoit Guerette, Ruben Queiro, Alexis Ogdie

494 subjects

Conclusión: Pacientes con baja o moderada actividad basal tenían mayor probabilidad de alcanzarLDA o REM con tto continuado de APR a la sem 52. En estos pacientes se observa que cuando alcanzanrespuesta parcial a la sem 16 se asocial a alcanzar mejor respuesta de cDAPSA a la sem 52.

DESCRIPTIVE COMPARISONS OF THE IMPACT OF APREMILAST AND METHOTREXATE MONOTHERAPY ON PATIENTS WITH OLIGOARTICULAR PSORIATIC ARTHRITIS IN THE CORRONA PSORIATIC ARTHRITIS/SPONDYLOARTHRITIS REGISTRYAlexis Ogdie1, Mei Liu2, Meghan Glynn2, Kelechi Emeanuru2, Leslie Harrold2,3, Sven Richter4, Benoit Guerette4, Philip J. Mease5

A los 6 meses: mejores resultados globales en el grupo de APR con respecto al de MTX, y comparables al de bDMARD.

•APR fue más usado que MTX en oligoartritis refractaria, con mayor mejoría y resultados comparables a bDMARD

A RANDOMIZED, PHASE 3, DOUBLE-BLIND TRIAL EXAMINING METHOTREXATE AND ETANERCEPT AS MONOTHERAPY OR IN COMBINATION FOR TREATING PSORIATIC ARTHRITIS: A COMPARISON OF THE COMPOSITE MEASURES USED TO EVALUATE DISEASE ACTIVITY

Philip J Mease, Dafna D Gladman, David Collier, Christopher T. Ritchlin, Philip Helliwell, Laura C Coates, Vibeke Strand, Lyrica Liu, Greg Kricorian, James Chung

A RANDOMIZED, PHASE 3, DOUBLE-BLIND TRIAL EXAMINING METHOTREXATE AND ETANERCEPT AS MONOTHERAPY OR IN COMBINATION FOR TREATING PSORIATIC ARTHRITIS: A COMPARISON OF THE COMPOSITE MEASURES USED TO EVALUATE DISEASE ACTIVITY

Philip J Mease, Dafna D Gladman, David Collier, Christopher T. Ritchlin, Philip Helliwell, Laura C Coates, Vibeke Strand, Lyrica Liu, Greg Kricorian, James Chung

ACHIEVEMENT OF PASDAS LOW DISEASE ACTIVITY AND VERY LOW DISEASE ACTIVITY IN PATIENTS WITH PSORIATIC ARTHRITIS TREATED WITH CERTOLIZUMAB PEGOL OVER 4 YEARS AND THE OVERLAP WITH DAPSA AND MDA DISEASE ACTIVITY TARGETSLaura C. Coates, Joseph F. Merola, Oliver Fitzgerald, Arthur Kavanaugh, Alice B. Gottlieb, William Tillett, Lars Bauer, Bengt Hoepken, Tommi Nurminen, Philip J. Mease, Philip Helliwell, Désirée van der Heijde

MULTICENTRE, RANDOMISED, OPEN-LABEL, ASSESSOR-BLINDED, PARALLEL-GROUP HEAD-TO-HEAD COMPARISON OF THE EFFICACY AND SAFETY OF IXEKIZUMAB VERSUS ADALIMUMAB IN PATIENTS WITH PSORIATIC ARTHRITIS NAIVE TO BIOLOGIC DISEASE-MODIFYING ANTI-RHEUMATIC DRUGS: 24-WEEK RESULTS,Philip J. Mease, Josef S. Smolen, Frank Behrens, Peter Nash, Soyi Liu Leage, LI Lingnan, Hasan Tahir, Melinda Gooderham, Eswar Krishnan, Paul Emery, Sreekumar Pillai, Philip Helliwell

MULTICENTRE, RANDOMISED, OPEN-LABEL, ASSESSOR-BLINDED, PARALLEL-GROUP HEAD-TO-HEAD COMPARISON OF THE EFFICACY AND SAFETY OF IXEKIZUMAB VERSUS ADALIMUMAB IN PATIENTS WITH PSORIATIC ARTHRITIS NAIVE TO BIOLOGIC DISEASE-MODIFYING ANTI-RHEUMATIC DRUGS: 24-WEEK RESULTS,Philip J. Mease, Josef S. Smolen, Frank Behrens, Peter Nash, Soyi Liu Leage, LI Lingnan, Hasan Tahir, Melinda Gooderham, Eswar Krishnan, Paul Emery, Sreekumar Pillai, Philip Helliwell

SECUKINUMAB IMPROVES AXIAL MANIFESTATIONS IN PATIENTS WITH PSORIATIC ARTHRITIS AND INADEQUATE RESPONSE TO NSAIDS: PRIMARY ANALYSIS OF THE MAXIMISE TRIAL

Xenofon Baraliakos1, Laura C Coates2, Laure Gossec3, Sławomir Jeka4, Antonio Mera Varela5, Barbara Schulz6, Michael Rissler6, Ayan Das Gupta7, Chiara Perella6, Effie Pournara6

EQUATOR, 16-week, multicenter, double-blind study in which patients with active PsA were randomized 1:1 to FIL 200 mg or PBO once daily

131 patients randomized (FIL: n=65; PBO: n=66),

RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED, MULTIPLE-DOSE, PHASE 2B STUDY TO DEMONSTRATE THE SAFETY AND EFFICACY OF TILDRAKIZUMAB, A HIGH-AFFINITY ANTI-INTERLEUKIN-23P19 MONOCLONAL ANTIBODY, IN PATIENTS WITH ACTIVE psoriatic arthritis,Philip J Mease, Saima Chohan, Ferran J García Fructuoso, Richard C Chou, Kristine E Nograles, Alan M Mendelsohn, Michael E Luggen

RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED, MULTIPLE-DOSE, PHASE 2B STUDY TO DEMONSTRATE THE SAFETY AND EFFICACY OF TILDRAKIZUMAB, A HIGH-AFFINITY ANTI-INTERLEUKIN-23P19 MONOCLONAL ANTIBODY, IN PATIENTS WITH ACTIVE psoriatic arthritis,Philip J Mease, Saima Chohan, Ferran J García Fructuoso, Richard C Chou, Kristine E Nograles, Alan M Mendelsohn, Michael E Luggen

ASSESSMENT OF DISEASE ACTIVITY USING RAPID3 AND EVALUATION OF TREATMENT EFFECT OF GUSELKUMAB IN PATIENTS WITH PSA: RESULTS FROM A RANDOMIZED PLACEBO-CONTROLLED PHASE 2 CLINICAL TRIALAtul Deodhar, L Bruce Kirkham, Proton Rahman, Philip Helliwell, Alice B. Gottlieb, Wolf-Henning Boehncke, Xie L. Xu, Chenglong Han

Gusel (n100) Placebo (n 49)

RAPID3 SCORE -5,81 -0.57

RAPID3 MID 50% 20%

RAPID3 REMISSION 14% 2,4%

TREATMENT WITH TOFACITINIB IN REFRACTORY PSORIATIC ARTHRITIS. MULTICENTER STUDY OF CLINICAL PRACTICEJosé Luis Martín-Varillas, Eva Galindez, Esteban Rubio Romero, Agusti Sellas-Fernández, Roberto Daniel Gonzalez Benitez, Beatriz Joven-Ibáñez, José Campos Esteban, Olga Rusinovich, Vanesa Calvo-Río, Francisco Ortiz-Sanjuán, Clara Ventín-Rodríguez, Luis Fernández-Dominguez, Antia Crespo Golmar, Ximena Elizabeth Larco Rojas, Manuel Moreno, Alejandro Escudero Contreras, Emma Beltrán, Rafael Melero, Maria Jose Moreno, Enrique Raya, Beatriz Arca, María-Luisa Peral, Olga Maiz, Raul Veroz Gonzalez, Alfonso Corrales, Natalia Palmou-Fontana, Belén Atienza-Mateo, J. Loricera, Miguel a. González-Gay, Ricardo Blanco

ARE THERE ANY DIFFERENCES IN THE EFFECTIVITY AND SAFETY OF CERTOLIZUMAB PEGOL IN PATIENTS WITH PSORIATIC ARTHRITIS ACCORDING THEIR GENDER?Rosa García, Manuel Fernandez-Prada, Arantxa Conesa, Jose Campos Esteban, Ana Urruticoechea-Arana, Alejandro Olive, Silvia Paredes, Delia Taverner, Carlos Gonzalez, RENACER

Basal 3 months12 months

F M F M F M

DAS28 (CRP); mean (SD) 4.7 (0.9) 4.5 (0.8) 3.9 (0.9) 3.9 (1.0) 3.7 (1.0) 3.4 (1.0)

TJC; mean (SD) 7.3 (5.1) 6.5 (4.4) 5.2 (4.3) 5.1 (4.3) 4.4 (4.3) 4.0 (4.3)

SJC; mean (SD) 5.2 (3.8) 4.8 (3.5) 3.8 (3.1) 3.9 (3.3) 3.6 (3.1) 3.7 (3.4)

Enthesitis, n (%)* 38 (21.3) 35 (25) 30 (16.9) 26 (18.6) 12 (9.8) 8 (9.8)

Dactlylitis, n (%)* 48 (26.4) 48 (34.8) 27 (14.8) 31 (22.5) 7 (5.6) 10 (12.5)

Presence of nail disease, n (%)*

21 (24.7) 28 (38.4) 17 (20.0) 25 (34.2) 5 (9.8) 10 (25.0)

CZP effectiveness at 1 year of treatment

EFFECTIVENESS AND SAFETY OF USTEKINUMAB 90 IN PATIENTS WITH PSORIATIC ARTHRITIS.REAL WORLD EVIDENCE STUDYEstefanía Pardo Campo, José andrés Lorenzo Martín, Lilyan Consuelo Charca Benavente, Sara alonso Castro, Mercedes Alperi-López, Luis Marcelino Arboleya Rodríguez, Francisco Javier Ballina-García, Rubén Queiró Silva

58 pacientes (37 mujeres, 21 varones, edad 55 ± 8.7 años. Desde julio 2017 hasta presente

No hay pacientes con alta actividad

En esta serie, UST 90 mg es eficaz y seguro. Probabilidad de alcanzar bajaactividad o remisión en el 75% de estos pacientes medido por DAPSA.

DAPSA REMISIÓN DAPSA BAJA ACTIV. DAPSA MODERADA ACTIV.

12.5 % 59,4 % 28,1%

DAPSA = NAD + NAT + PCR + Actividad + Dolor Estatus Actividad: - Remisión: 0-4

- Act. Baja: 5-14 - Act. Moderada: 15-28 - Act. Alta: > 28

EFFECTIVENESS OF BIOLOGIC THERAPY ON DISEASE ACTIVITY IN ANKYLOSING SPONDYLITIS: A BIOBADASER III OBSERVATIONAL STUDYValentina Emperiale, Carlos Sánchez-Piedra, Cristina Bohórquez, María Colazo, Carlos Fernández-López, Noemí Busquets, Inmaculada Ros, J. M. Blanco, Manuel Moreno, Jose Campos Esteban, Carlos Rodríguez-Escalera, Fernando Sánchez-Alonso, Juan Jesus Gomez-Reino11

INFLAMMATORY BOWEL DISEASES AMONG SECUKINUMAB-TREATED PATIENTS: FIRST RESULTS OF THE MISSIL REGISTRYJean-Guillaume Letarouilly, Benjamin Pariente, Philippe Goupille, Pascal Claudepierre, Stephane Varin, Sylvain Lanot, Emmanuelle Dernis, Loïc Le Dantec, Philippe Gaudin, Denis Jullien, Thao Pham, Rene-Marc Flipo

12 casos son comunicados entre Febrero y Diciembre 2018 : 11 con enfermedad de Crohn de nuevo inicio y 1 con colitis ulcerosa.Edad media 51 ± 14.3 años 8/12 mujeres.6 casos son EspA axial, 3 periféricas y 3 mixtas9/10 son HLA-B27 positivo.

La enf. de Crohn fue principalmente localizada en ileon, colon y recto. La media de comienzo de los síntomas fue 4.9 ± 5.6 meses