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Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

15.09. - 18.09.2021, virtuell

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Baseline calprotectin and visfatin levels predict radiographic spinal progression after 2 years in ankylosing spondylitis patients on TNF inhibitor therapy

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  • Judith Rademacher - Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Berlin; Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin
  • Mark Siderius - University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen
  • Laura Gellert - Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Berlin
  • Freke Wink - Medical Center Leeuwarden, Department of Rheumatology, Leeuwarden
  • Maryna Verba - Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Berlin
  • Fiona Maas - University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen
  • Lorraine M. Tietz - Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Berlin
  • Denis Poddubnyy - Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Berlin
  • Anneke Spoorenberg - University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen
  • Suzanne Arends - University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). sine loco [digital], 15.-18.09.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocSpA.05

doi: 10.3205/21dgrh143, urn:nbn:de:0183-21dgrh1435

Veröffentlicht: 14. September 2021

© 2021 Rademacher et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

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Introduction: The objective of this study was to analyse whether biomarker of inflammation, bone turnover and adipokines at baseline or their change after 3 months or 2 years can predict spinal radiographic progression after 2 years in AS patients treated with TNF-α inhibitors (TNFi).

Methods: 137 consecutive AS patients from the Groningen Leeuwarden Axial Spondyloarthritis (GLAS) cohort were included before starting TNFi. The following serum biomarkers were measured at baseline, 3 months and 2 years with ELISA:

Markers of inflammation: calprotectin, matrix metalloproteinase-3 (MMP-3), vascular endothelial growth factor (VEGF)

Markers of bone turnover: bone-specific alkaline phosphatase (BALP), C-terminal telopeptide (sCTX), osteocalcin (OC), osteoprotegerin (OPG), procollagen typ I/II N-terminal propeptide (PINP; PIINP), sclerostin.

Adipokines: high-molecular-weight(HMW)-adiponectin, leptin, visfatin

Logistic regression was performed to examine the association between biomarker values and radiographic progression. Multivariable models were adjusted for mSASSS or syndesmophytes at baseline, elevated CRP (≥5mg/l), smoking status, male gender, symptom duration, BMI, and baseline biomarker level (the latter in models with biomarker change).

Results: Serum levels of biomarkers of inflammation and bone formation showed significant changes under TNFi therapy, whereas adipokine levels were not altered from baseline.

Figure 1 [Fig. 1]

Univariable logistic regression revealed significant associations of baseline visfatin (OR=1.106 [95%CI 1.007-1.215]) and sclerostin levels (OR=1.006 [1.001-1.011]) with mSASSS progression after 2 years. Baseline sclerostin was also associated with syndesmophyte progression (OR=1.007 [1.001-1.013]). In multivariable logistic analysis, only baseline visfatin level remained significantly associated (OR=1.465 [1.137-1.889]). Furthermore, baseline calprotectin showed a positive association with both, mSASSS (OR=1.195 [1.055-1.355]) and syndesmophyte progression (OR=1.107 [1.001-1.225]) when adjusting for known risk factors.

Univariable logistic regression showed that change of sclerostin after 3 months was associated with syndesmophyte, change of PINP level after 2 years was associated with mSASSS and change of visfatin after 2 years was associated with both measures of radiographic progression. However, those associations were lost in multivariable analysis.

Conclusion: Independent of known risk factors, baseline calprotectin and visfatin levels were associated with radiographic spinal progression after 2 years of TNFi. Although biomarkers of inflammation and bone formation showed significant changes under TNFi, these changes were not significantly related to radiographic spinal progression.

Disclosures: None declared