Correlation And Impacted Factors Analysis Of Clinical And Imaging Remission In Patients With Axial Spondyloarthritis

Objective To investigate incidences of clinical treat-to-target and imaging remission in patients with axial spondyloarthritis(axSpA),and analysis the relevant influenced factors.Methods According to past treatment programs,ankylosing spondylitis disease activity scores based on C-reactive protein(CRP)(ASDAScrp)and Spondyloarthritis Research Consortium of Canada(SPARCC)scores,233 patients with axSpA were divided into different groups respectively.Clinical data of each group were compared.125 patients followed up at least 6 months were divided into two groups: anti-tumor necrosis factor(TNF)-α treatment group and non anti-TNF-α treatment group.Comparison of the improvement of clinical remission rate,imaging remission rate and disease parameters before and after different treatment.Risk factors for clinical and imaging remission were analyzed by multivariate logistic regression analysis.Results Rate of clinical remission was 25.3% in patients with axSpA.Rate of imaging non-remission in clinical remission group(32.2%)was lower than that in clinical non-remission group(56.3%,P<0.05).CRP in clinical remission group was lower than that in clinical non-remission group,and ratio of patients receiving anti-TNF-αtreatment was higher than that in clinical non-remission group(P<0.05).ASDAScrp in imaging remission group was lower than that in imaging non-remission group,and ratio of patients receiving anti-TNF-α treatment was higher than that in imagingnon-remission group(P<0.05).Rate of clinical remission and imaging remission in non standard treatment group were lower than those in anti-TNF-α treatment group(P<0.05).Rate of clinical compliance and imaging remission in anti-TNF-α group were significantly higher than those before treatment.Rate of clinical and imaging remission in CRP positive group after anti-TNF-α treatment or non-anti-TNF-α treatment were significantly higher than those before(P<0.05).Rate of imaging remission in CRP negative group was significantly higher than that before(P<0.05).Rate of clinical and imaging remission in smoking group,non-smoking group,male,female and HLA-B27 positive group after anti-TNF-α treatment were significantly higher than those before(P<0.05).Only rate of imaging remission in HLA-B27 negative group after anti-TNF-α treatment was higher than that befor(P<0.05).Rate of clinical remission in female with non-anti-TNF-α treatment ware higher than that in male(P<0.05).Results of multivariate logistic regression analysis showed that CRP rise was risk factor for clinical non-remission in axSpA(P<0.001),while ASDAScrp rise was risk factor for imaging non-remission(P<0.05).Anti-TNF-α treatment was protective factor for both clinical and imaging remission(P<0.05).Conclusion Rate of clinical remission in axSpA is still low.CRP and ASDAScrp rise are risk factors for clinical and imaging non-remission in axSpA respectively,continuous NSAIDs treatment(more than 1 year)can effectively improve clinical and MRI inflammation of patients,while anti-TNF-α treatment is more conducive to clinical compliance and imaging remission.