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Background: Axial spondyloarthritis (axSpA) is associated with accelerated atherosclerosis driven by chronic inflammation. Achieving LDA may result in significant benefits in articular disease, little is known about its effect on extra-articular disease, including CVD risk in axSpA. Objectives: To investigate the effect of achieving Ankylosing Spondylitis Disease Activity Score (ASDAS) low disease activity (LDA) using a protocolized treatment strategy on the progression of subclinical atherosclerosis and arterial stiffness in axial spondyloarthritis (axSpA) patients. Methods: One hundred consecutive AxSpA patients will participate in this 2-year prospective, hospital-based, cohort study. All participants will receive 2 years of tight-control treatment. Treatment will be adjusted according to a standardized protocol every 3-6 monthly aiming at ASDAS LDA (ASDAS Results: In this interim analysis, a total of 56 axSpA patients (age: 38±10 years, 43 (76.8%) male) who completed 2 year of follow-up were included. A significant improvement in disease activity was observed after 2 years of treatment (ASDAS-CRP at baseline: 2.9±0.6 vs 1.9±0.7 at year 2, pP=0.025) and max IMT (β: -0.06, 95%CI -0.12 to -0.004, P=0.038) after adjustment for covariates compared to the non-sLDA group. However, there were no significant differences in the progression of carotid plaque and arterial stiffness markers between the two groups in the multivariate analysis. Conclusion: Patients with AxSpA who are able to achieve sLDA through a protocolized treatment algorithm experience reduced progression of subclinical atherosclerosis compared to patients who cannot achieve sLDA. This indicates that effective suppression of inflammation in AxSpA patients who reach sLDA may potentially lower CV risk by preventing progression of subclinical atherosclerosis. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.
Meng et al. (Sat,) studied this question.
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