Title:Associated Factors with the Severity of Hip Involvement in Spondyloarthritis and Efficacy of TNF α Inhibitors in these Patients
Volume: 18
Issue: 1
Author(s): Maroua Slouma, Safa Rahmouni*, Rim Dhahri, Elhem Cheour, Imen Gharsallah, Leila Metoui and Bassem Louzir
Affiliation:
- Department of Rheumatology, Military Hospital, Tunis, Tunisia
- Tunis El Manar University, Tunis, Tunisia
Keywords:
Hip joint, spondylarthritis, tumor necrosis factor inhibitors, BASMI, lequesne index, TNFi.
Abstract: Introduction: Hip involvement in patients with spondyloarthritis is responsible for disability
and functional impairment. Its treatment is not codified.
Our study aimed to determine the associated factors with moderate and severe hip involvement in
spondyloarthritis patients. It also aimed to assess the efficacy of tumour necrosis factor inhibitors
(TNFi) on hip disease.
Methods: We conducted a cross-sectional study, including 44 spondyloarthritis patients with hip involvement.
Hip involvement was diagnosed based on radiographic findings. We assessed the following
parameters: Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing
Spondylitis Radiology Index (BASRI), patient global assessment (PGA), and Lequesne index. We
compared these parameters and the mean radiographic joint space width between the time of the
study to those right before the use of TNFi.
Results: Hip involvement was bilateral in 31 patients. The mean age was 44.56±12.21 years. There
were 29 men. Severe and moderate involvement (BASRI-hip>3) was reported in 21 hips from 75
affected. These patients were older and had longer diagnosis delays than patients with BASRI-
hip<3. They had a higher body mass index and more limited spine mobility (BASMI). Functional
hip impairment assessed by the Lequesne index was higher in these patients.
TNFi prescribed in 23 patients with hip involvement, led to an improvement in the Lequesne index
(12.75 vs 7.5, p: 0.001) and PGA (7 vs 2, p: 0.001). However, the mean joint space width remained
unchanged (3.8 vs 3.7mm, p: 0.532).
Conclusion: Our study showed that higher body mass and Lequesne indexes are associated with
moderate and severe hip involvement. TNFi may improve both the Lequesne index and PGA and
stabilize the radiological findings.
