AB1160 A BENCHMARKING STUDY EVALUATING THE BURDEN OF AXIAL SPONDYLOARTHRITIS IN SPAIN COMPARED WITH THE REST OF EUROPEAN COUNTRIES. RESULTS OF THE SPANISH ATLAS AND EMAS STUDIES.

Abstract

Background:Benchmarking studies in axial spondyloarthritis (axSpA) may provide evidence of disparities, making it necessary to improve the healthcare and management of these patients.Objectives:To evaluate differences between Spain and the rest of Europe (RoE) in relation to sociodemographic characteristics, life habits, and patient-reported outcomes (PROs) in axSpA patients.Methods:Data from 2,846 unselected patients from the European Map of Axial Spondyloarthritis (EMAS) were collected through an online survey, with a comparative analysis of 680 Spanish patients (2016) and 2,166 patients living in 12 other European countries (2017-2018). Socio-demographic characteristics, life habits, and PROs [BASDAI (0-10), spinal stiffness (3-12), and psychological distress (0-12, General Health Questionnaire GHQ-12)] were compared. The Χ2test was used for qualitative variables and the Mann-Whitney test applied for quantitative variables.Results:Data from 680 (23.9%) Spanish patients were compared to 2,166 (76.1%) patients from the RoE. Compared to Spain, the RoE patients reported a higher percentage of females (64.1% vs 52.5%; p<0.001), university studies (51.7% vs 36.9%; p<0.001) and higher income per family member (€1,173.5 vs €823.2; p<0.001). In Spain, the proportion of respondents who were members of patient associations was higher than in RoE (44.3% vs 37.2%; p<0.001) (Table 1). Also compared to RoE, Spanish patients showed a greater diagnostic delay (8.5±7.7 vs 7.2±8.6; p<0.001), HLA-B27 carriership (77.1% vs 70.1%; p=0.003), and disease activity (5.7±2.0 vs 5.4±2.0; p=0.024). Despite lower diagnosis of anxiety and depression rates, Spanish patients reported greater psychological distress (5.7±4.5 vs 4.8±4.0; p<0.001). However, RoE patients declared greater spinal stiffness compared to Spanish patients (7.8±2.4 vs 7.5±2.7; p=0.009) (Table 2).Table 1.Comparison of socio-demographic characteristics and lifestyle habits of axSpA patients in Spain and in RoESpain (n = 680)Mean ± SD; n (%)RoE (n = 2,166)Mean ± SD; n (%)p-valueAge (Years)45.7 ± 10.843.4 ± 12.6<0.001*Gender (Female)357 (52.5)1389 (64.1)<0.001*Educational level - No schooling9 (1.3)23 (1.1)<0.001* - Primary school119 (17.5)144 (6.6) - High school301 (44.3)880 (40.6) - University251 (36.9)1,119 (51.7)Monthly income (€) per household member823.2 ± 656.41,173.5 ± 928.8<0.001*Smoking - Non-smoker or socially417 (71.3)1,679 (77.5)<0.001* - Less than 10 cig/day24 (4.1)111 (5.1) - More than 10 cig/day144 (24.6)376 (17.4)Alcohol - Never or occasionally503 (86.0)1,723 (79.5)<0.001* - 1–2 times per week37 (6.3)292 (13.5) - More than 2 per week45 (7.7)151 (7.0)Member of a patient support group301 (44.3)806 (37.2)0.001*Table 2.Comparison of PROs of axSpA patients between Spain and RoESpain (n = 680)Mean ± SD; n (%)RoE (n = 2166)Mean ± SD; n (%)p valueDiagnostic delay, years8.5 ± 7.77.2 ± 8.6<0.001*HLA-B27 (positive)391 (77.1)892 (70.1)0.003*BASDAI (0–10)5.7 ± 2.05.4 ± 2.00.024*Spinal Stiffness (3–12)7.5 ± 2.77.8 ± 2.40.009*GHQ-12 (0–12)5.7 ± 4.54.8 ± 4.0<0.001*Anxiety135 (19.9)674 (33.1)<0.001*Depression100 (14.7)610 (30.0)<0.001*Conclusion:In this study, significant differences between Spanish and RoE patients were observed for the burden of the disease in patients with axSpA. Patients in Spain experience a greater diagnostic delay and greater psychological distress.Acknowledgments:Funded by Novartis Farmacéutica S.A.Disclosure of Interests:Marco Garrido-Cumbrera: None declared, Eduardo Collantes-Estévez Grant/research support from: ROCHE and Pfizer., Speakers bureau: ROCHE, Lilly, Bristol and Celgene., Victoria Navarro-Compán Consultant of: Abbvie, Lilly, Novartis, Pfizer, UCB, Speakers bureau: AbbVie, MSD, Lilly, Novartis, Pfizer, UCB, Pedro Zarco Montejo Grant/research support from: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Speakers bureau: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Carlos Sastré Employee of: YES; I´m Medical Advisor in Novartis Spain, Sergio Sanz-Gómez: None declared, Pedro Plazuelo-Ramos: None declared, Jordi Gratacos-Masmitja Grant/research support from: a grant from Pfizzer to study implementation of multidisciplinary units to manage PSA in SPAIN, Consultant of: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Speakers bureau: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly