rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2016-1S-55-59rsp-2254Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHЭВОЛЮЦИЯ АКСИАЛЬНОГО СПОНДИЛОАРТРИТА ЗА 12 МЕСЯЦЕВ НАБЛЮДЕНИЯ КОГОРТЫ К ОРСАРTHE EVOLUTION OF AXIAL SPONDYLOARTHRITIS DURING 12-MONTH FOLLOW-UP STUDY OF A CORSAR COHORTЭрдесШ. Ф.ErdesSh. F.

Erdes Shandor

123456_57@mail.ruДубининаТ. В.DubininaT. V.РумянцеваО. А.RumyantsevaO. A.ДёминаА. Б.DyominaA. B.ГубарьЕ. Е.GubarE. E.РумянцеваД. Г.RumyantsevaD. G.Научно-исследовательский институт ревматологии имени В.А. Насоновой, МоскваРоссияV.A. Nasonova Research Institute of Rheumatology, MoscowRussian Federation201615092016541Sприложение 15559Copyright © Эрдес Ш.Ф., Дубинина Т.В., Румянцева О.А., Дёмина А.Б., Губарь Е.Е., Румянцева Д.Г., 20162016Эрдес Ш.Ф., Дубинина Т.В., Румянцева О.А., Дёмина А.Б., Губарь Е.Е., Румянцева Д.Г.Erdes S.F., Dubinina T.V., Rumyantseva O.A., Dyomina A.B., Gubar E.E., Rumyantseva D.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2254

До последнего времени  нет ясности в вопросе нозологической самостоятельности нерентгенологического аксиального спондилоартрита (нр-аксСпА). В решении  этого вопроса могут помочь когортные  исследования. В ФГБНУ  НИИР имени В.А. Насоновой в 2013 г. начато формирование когорты КоРСаР для изучения эволюции  и терапевтической тактики при аксСпА. Настоящее сообщение посвящено предварительным результатам 12-месячного наблюдения за пациентами когорты КоРСаР.

Материал и методы

Материал и методы. Набор когорты осуществляется методом последовательного включения всех пришедших на консультативный прием пациентов с аксСпА с длительностью  симптоматики <5 лет. Пациентов обследовали в соответствии  с рекомендациями Международной рабочей группы по изучению анкилозирующего спондилита  (ASAS) при включении и через 12 мес. Включено 94 пациента  с аксСпА,  из которых в предварительный анализ по изучению эволюции  аксСпА вошли 54 больных, наблюдавшихся ≥12 мес (средний  возраст на момент включения в исследование составил 27,1±5,5  года, средняя продолжительность заболевания – 22,4±15,1 мес); 49 (90,7%) больных были позитивны по HLA-B27. Из 54 больных у 31 был анкилозирующий спондилит  (АС), а у 23 – нр-аксСпА.

Результаты и обсуждение

Результаты и обсуждение. Пациенты с АС и нр-аксСпА практически не различались между собой по основным клиническим параметрам  (наличию  артрита, энтезитов, индексам  BASDAI, ASDAS-СРБ и BASFI).

К концу 12-го месяца наблюдения практически все показатели  воспалительной активности, кроме СОЭ, уменьшились в обеих группах почти в 2 раза. У 9 (39%) пациентов с нр-аксСпА за 12 мес развился  рентгенологически  выявляемый сакроилиит и был подтвержден диагноз – АС.

Выводы

Выводы. За 12 мес наблюдения у 39% пациентов с нр-аксСпА развился  рентгенологически выявляемый сакроилиит.  Нр-аксСпА следует рассматривать как начальную стадию АС. 

Until recently there is no clarity in the nosological independence of non-radiographic axial spondyloarthritis  (nraxSpA). Cohort studies can assist in solving this problem. In 2013, the V.A. Nasonova Research Institute of Rheumatology started to form a Cost and Resource utilization Study in Antiretroviral treated patients (CoRSaR) cohort to investigate the evolution of nr-axSpA and treatment policy for this condition.  This communication deals with the preliminary results of a 12-month follow-up study of the CoRSaR  cohort.

Subjects and methods

Subjects and methods. The cohort was recruited  from all consecutive patients with a < 5-year history of nr-axSpA who sought for medical advice and treatment. The patients were examined in accordance  with the Ankylosing Spondylitis Assessments (ASAS) International Working Group  guidelines at inclusion and after 12 months.

A total of 94 patients with axSpA were enrolled; 54 patients out of them were included into a preliminary analysis of the evolution of axSpA; their mean age at inclusion was 27.1±5.5  years and the mean disease duration  was 22.4±15.1 months;  49 (90.7%) patients were HLA-B27 positive. 31 of the 54 patients had ankylosing spondylitis(AS) and 23 had nr-axSpA.

Results and discussion

Results and discussion. The patients with AS and those with nr-axSpA showed virtually no difference in main clinical parameters,  such as the presence of arthritis, enthesitis, BASDAI, ASDAS-CRP, and BASFI. By the end of the 12month follow-up, both groups virtually displayed almost a double reduction  in all inflammatory markers but erythrocyte sedimentation rate. Nine (39%) patients with nr-axSpA developed radiographic sacroiliitis over 12 months and the diagnosis of AS was confirmed.

Conclusion

Conclusion. 39% patients with nr-axSpA developed radiographic sacroiliitis at the 12-month follow-up. Nr-axSpA should be regarded as an early stage of AS.

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The authors declare that there are no conflicts of interest present.