IBAÑEZ VODNIZZA, SEBASTIAN EDUARDO
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IBAÑEZ VODNIZZA, SEBASTIAN EDUARDO
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s.ibanez@udd.cl
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57211180704

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Spondyloarthritis in Chile

2018 , IBAÑEZ VODNIZZA, SEBASTIAN EDUARDO , VALENZUELA LETELIER, OMAR ANTONIO

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OP0047 IDENTIFICATION OF CLINICAL PHENOTYPES IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS, PERIPHERAL SPONDYLOARTHRITIS AND PSORIATIC ARTHRITIS ACCORDING TO PERIPHERAL MUSCULOSKELETAL MANIFESTATIONS: A CLUSTER ANALYSIS IN THE INTERNATIONAL ASAS-PERSPA STUDY

2021 , C. López-Medina , S. Chevret , A. Moltó , J. Sieper , M. T. Duruöz , U. Kiltz , B. Zorkany , N. Hajjaj-Hassouni , R. Burgos-Vargas , J. Maldonado-Cocco , N. Ziade , M. Gavali , V. Navarro-Compán , S. F. Luo , A. Biglia , T. J. Kim , M. Kishimoto , F. Pimentel Dos Santos , J. Gu , L. Muntean , F. A. Van Gaalen , P. Géher , M. Magrey , S. Ibáñez , W. Bautista-Molano , W. P. Maksymowych , P. M. Machado , R. B. M. Landewé , D. Van der Heijde , M. Dougados , IBAÑEZ VODNIZZA, SEBASTIAN EDUARDO

Background:Patients with a diagnosis of Spondyloarthritis (SpA) and Psoriatic Arthritis (PsA) may have predominant axial or peripheral symptoms, and the frequency and distribution of these symptoms may determine the clinical diagnosis by the rheumatologist (“clinical clusters”). Clustering analysis represents an unsupervised exploratory analysis which tries to identify homogeneous groups of cases (“statistical clusters”) without prior information about the membership for any of the cases.Objectives:To identify “statistical clusters” of peripheral involvement according to the specific location of these symptoms in the whole spectrum of SpA and PsA (without prior information about the diagnosis of the patients), and to evaluate whether these “statistical clusters” are in agreement with the “clinical clusters”.Methods:Cross-sectional and multicentre study with 24 participating countries. Consecutive patients considered by their treating rheumatologist as suffering from either PsA, axial SpA (axSpA) or peripheral SpA (pSpA) were enrolled. Four different cluster analyses were conducted: the first one using information about the specific location from all the peripheral musculoskeletal manifestations (i.e., peripheral arthritis, enthesitis and dactylitis), and thereafter a cluster analysis for each peripheral manifestation individually. Multiple correspondence analyses and k-means clustering methods were used. Distribution of peripheral manifestations and clinical characteristics were compared across the different clusters.Results:4465 patients were included in the analysis. Two clusters were found with regard to the location of all the peripheral manifestations (Fig. 1). Cluster 1 showed a low prevalence of peripheral manifestations in comparison with cluster 2; however, when peripheral involvement appeared in cluster 1, this was mostly represented by arthritis of hip, knee and ankle, as well as enthesitis of the heel. Patients from cluster 1 showed a higher prevalence of males (63% vs 44%), HLA-B27 positivity (69% vs 38%) and axial involvement (80% vs 52%), as well as more frequent diagnosis of axSpA (66% vs 21%) and more frequently fulfilling the ASAS axSpA criteria (69% vs. 41%). Patients from cluster 2 showed a higher prevalence of psoriasis (63% vs 25%), a more frequent diagnosis of PsA (61% vs 19%), and they fulfilled more frequently the peripheral ASAS (26% vs 11%) and the CASPAR criteria (57% vs 19%).Figure 1.Distribution of the peripheral involvement across clustersThree clusters were found with regard to the location of the peripheral arthritis. Clusters 2 and 3 showed a high prevalence of peripheral joint disease, although this was located more predominantly in the lower limbs in cluster 2, and in the upper limbs in cluster 3. Cluster 1 showed a higher prevalence of males, HLA-B27 positivity, axial involvement, a lower presence of psoriasis, a more frequent diagnosis of axSpA and fulfilling the ASAS axSpA criteria in comparison with clusters 2 and 3, respectively. Clusters 2 and 3 showed a higher prevalence of enthesitis and dactylitis in comparison with cluster 1, a more frequent diagnosis of PsA and fulfillment of the CASPAR criteria.Information about the location of enthesitis exhibited three groups: cluster 1 showed a very low prevalence of enthesitis, while cluster 2 and 3 showed a high prevalence of enthesitis, with a predominant involvement of axial enthesis in cluster 2 and peripheral enthesitis in cluster 3.Finally, the analysis of dactylitis also exhibited three clusters that showed a very low prevalence of dactylitis, predominantly toes and predominantly fingers involvement, respectively.Conclusion:These results suggest the presence of heterogeneous patterns of peripheral involvement in SpA and PsA patients without clearly defined groups, confirming the clear overlap of these peripheral manifestations across the different underlying diagnoses.Acknowledgements:This study was conducted under the umbrella of ASAS with unrestricted grant of Abbvie, Pfizer, Lilly, Novartis, UCB, Janssen and Merck.Disclosure of Interests:None declared

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SAT0239 LONG TERM OUTCOMES IN PATIENTS WITH ANTIPHOSPHOLIPID SYNDROME AND RENAL ARTERY STENOSIS

2020 , VILLAR COFRÉ, MARÍA JOSÉ , S. Sangle , IBAÑEZ VODNIZZA, SEBASTIAN EDUARDO , D. D’cruz

Background:Antiphospholipid syndrome (APS) is characterized by thrombosis and obstetric morbidity in the context of positive antiphospholipid antibody markers. More than a quarter of hypertensive APS patients (26%) have renal artery stenosis (RAS) (1). Treatment includes anticoagulation, blood pressure control and management of cardiovascular risks. In some cases, the severity of the renal vascular lesion requires surgical interventionObjectives:To evaluate long term outcomes in APS patients with RAS.Methods:Retrospective database study. All records of APS patients with RAS were analyzed and demographic variables, comorbidities, treatment received, renal outcome and mortality were recorded.Uni- and multivariate analyses were performed by logistic regression with death and chronic kidney disease (CKD) as dependent variables. In the multivariate analysis, the covariates considered were age at diagnosis of stenosis, diabetes, smoking, dyslipidemia, unilateral or bilateral stenosis, stenosis greater than 50%, surgery and the use of immunosuppressants, anticoagulation and statins.Research and development office has approved this study.Results:33 RAS patients were analyzed. Diagnosis of RAS was made by MRI renal angiography and in some cases by CT angiogram and intra-arterial digital subtraction angiography. Patient characteristics are detailed in Table 1. The median duration of follow-up was 152 months (IQR 65).Table 1.Patient Characteristics.N° Patients33Age median48 (IQR 16)Smokers%18.1(6)Comorbidities %Diabetes mellitus type 2 6 (2) Hypertension 100(33)High LDL 36.3(12)Primary APS %39.4 (13)Secondary APS %60.6 (20)Unilateral RAS%75.8 (25)Bilateral RAS%24.2 (8)Degree of stenosis< 30% 15.1 (5)30-50% 30.3 (10)50-80% 33.3 (11)>80% 21.2 (7)Treatment%Medical treatment 75.7 (25)Surgical treatment 30.3 (10)Renal biopsy was performed in 3 patients: crescentic glomerulonephritis was found in 2 patients and one had a thrombotic microangiopathy.Treatment: 25 patients (75.7%) were anticoagulated with vitamin K antagonists, 19 (57.6%) received immunosuppressive therapies, 18 (54.5%) were on statins. Ten patients (30.3%) were managed surgically with balloon angioplasty. Restenosis occurred in 4/10 patients (40%) and percutaneous renal artery stenting was performed successfully in all four. Ten patients died (30.3%). Renal outcomes are shown in Table 2.Table 2.Outcome in APS with RAS PatientsN %Died 10 30.3Transplanted 1 3Renal Dysfunction 17 51.5CKD Stage III 10 30.3CKD Stage IV 4 12.1CKD Stage V 3 9In the univariate analysis, surgery was significantly associated with a lower probability of reaching CKD (p=0.042; OR 0.2; 95% CI 0.03-0.94). In the multivariate analysis, the tendency to benefit from surgery was maintained but the statistical significance was lost, probably due to the low number of patients.In the subgroup analysis, the tendency to benefit from surgery was maintained in patients with or without anticoagulation, immunosuppressants, statins, with primary or secondary APS, with uni- or bilateral stenosis, with or without dyslipidemia, but this benefit was lost in smokers independent of the grade of stenosis.Conclusion:RAS is a treatable cause of hypertension and a poor prognostic marker in APS patients.In this study, APS patients with RAS who underwent intervention with angioplasty or stenting had a trend to a lower probability of developing CKD in contrast to studies in atherosclerotic RAS. The beneficial effect of surgery was lost in smoking patients. In this relatively young population mortality was high.References:[1]Sangle SR, D’Cruz DP, Abbs IC, Khamashta MA, Hughes GR. Renal artery stenosis in hypertensive patients with antiphospholipid (Hughes) syndrome: outcome following anticoagulation. Rheumatology (Oxford) (2005) 44:372–7.Disclosure of Interests:María José Villar: None declared, Shirish Sangle: None declared, Sebastian Ibáñez Consultant of: Novartis, Paid instructor for: Bristol Myers, Speakers bureau: Abbvie, David d’cruz Grant/research support from: GlaxoSmithKline

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Identification of Clinical Phenotypes in Patients with Axial Spondyloarthritis, Peripheral Spondyloarthritis and Psoriatic Arthritis According to Peripheral Musculoskeletal Manifestations: A Cluster Analysis in the International ASAS-PerSpA Study

2020 , IBAÑEZ VODNIZZA, SEBASTIAN EDUARDO , Lopez-Medina, Clementina , Chevret, Sylvie , Molto, Anna , Sieper, Joachim , Duruoz, Mehmet Tuncay , Kiltz, Uta , El-Zorkany, Bassel , Hajjaj-Hassouni, Najia , Burgos-Vargas, Ruben , Maldonado-Cocco, Jose , Ziade, Nelly , Gavali, Meghna , Navarro-Compan, Victoria , Luo, Shue Fen , Biglia, Alessandro , Tae-woo Kim , Kishimoto, Mitsumasa , Pimentel-Santos, Fernando , Gu, Jieruo , Muntean, Laura , van Gaalen, Floris , Geher, Pal , Magrey, Marina , Bautista-Molano, Wilson , Maksymowych, Walter , Machado, Pedro M , Landewe, Robert , van der Heijde, Desiree

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SPONDYLOARTHRITIS IN A POPULATION WITHOUT ACCESS TO BIOLOGICS IN 2017-PADRE HURTADO HOSPITAL EXPERIENCE

2018 , IBAÑEZ VODNIZZA, SEBASTIAN EDUARDO , VALENZUELA LETELIER, OMAR ANTONIO , VILLAR COFRÉ, MARÍA JOSÉ , SILVA LABRA, FRANCISCO , MOGOLLONES, KATHERINE , MARDONES, CLAUDIA , POBLETE DE LA FUENTE, MARÍA PAZ

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Approach to the Patient with Axial Spondyloarthritis and Suspected Inflammatory Bowel Disease

2020 , IBAÑEZ, SEBASTIAN , María Paz Poblete De La Fuente , Elisa Catalina Parra Cancino

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First Report of Tocilizumab Use in a Cohort of Latin American Patients Hospitalized for Severe COVID-19 Pneumonia

2020 , VALENZUELA LETELIER, OMAR ANTONIO , IBAÑEZ, SEBASTIAN , M. Cecilia Poli , ROESSLER VERGARA, PATRICIA ANDREA , AYLWIN RAMIREZ, MABEL CRISTINA , Gigia Roizen , IRURETAGOYENA BRUCE, MIRENTXU INES , Vivianne Agar , Javiera Donoso , Margarita Fierro , José Montes

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Prevalence and Distribution of Peripheral Musculoskeletal Manifestations in Axial Spondyloarthritis, Peripheral Spondyloarthritis and Psoriatic Arthritis: Results of the International, Cross-sectional ASAS-PerSpA Study

2020 , IBAÑEZ VODNIZZA, SEBASTIAN EDUARDO

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Axial Spondyloarthritis Patients Report Important Impairments in Daily Life and Work Ability - a Web Survey in 472 Patients

2019 , IBAÑEZ VODNIZZA, SEBASTIAN EDUARDO , VALENZUELA LETELIER, OMAR ANTONIO , Rianne Van Bentum , Irene Van Der Horst-bruinsma

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Use of Corticosteroids in COVID-19

2020 , ROESSLER VERGARA, PATRICIA ANDREA , Gigia Roizen , IBAÑEZ, SEBASTIAN , VALENZUELA LETELIER, OMAR ANTONIO

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