Abstract
ObjectivesThe aim of this study was to compare the symptoms, treatment patterns, and quality of life (QoL) of ankylosing spondylitis (AS) patients to non-radiographic axial spondyloarthritis (nr-axSpA) patients in the USA.MethodA cross-sectional survey was conducted with rheumatologists and their consulting patients in the USA from June through August 2018. Patients who had a rheumatologist confirmed diagnosis of AS and nr-axSpA were eligible to participate. Patient demographics, symptoms, and medication use were reported by the rheumatologist, while work disability and QoL measures were reported by the patient. Patient demographics, symptoms, QoL and treatment patterns of AS and nr-axSpA patients were compared using parametric tests and non-parametric tests when appropriate.ResultsA total of 515 AS patients and 495 nr-axSpA patients were included in this analysis. A higher proportion of AS patients were male (p < 0.001), older (p = 0.014), and more likely to be prescribed a biologic (p < 0.0001). On average, AS patients experienced slightly more symptoms at diagnosis (p = 0.023); however, nr-axSpA patients were more likely to experience enthesitis (p = 0.048) and synovitis (p = 0.003). Patient reported outcomes such as the ASAS Health Index (p = 0.171), ASQoL (p = 0.296), BASDAI (p = 0.124), and WPAI (p = 0.183) were similar between AS and nr-axSpA patients after adjusting for confounding variables such as medication use.ConclusionsAS and nr-axSpA patients share the same clinical features. The burden of the disease, as assessed by QoL measurements, is also similar in AS and nr-axSpA patients; however, despite these similarities, patients with nr-axSpA are less likely to be treated with a biologic.Key Points• Ankylosing spondylitis and non• radiographic axial spondyloarthritis patients share similar clinical features and burden of disease.• Quality of life is similar among ankylosing spondylitis and non• radiographic axial spondyloarthritis after adjusting for current treatment patterns.
Highlights
Axial spondyloarthritis is a chronic inflammatory disease that mainly affects the axial skeleton and sacroiliac joints [1]
ankylosing spondylitis (AS) in its most advanced expression can be characterized by severe spinal immobility and functional disability caused by fusion of the spine [8]
This analysis of a large real-world survey of rheumatologists and their axSpA patients provides a comparison of AS and nr
Summary
Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that mainly affects the axial skeleton and sacroiliac joints [1]. AxSpA is an umbrella term that includes patients with ankylosing spondylitis (AS) [3] and non-radiographic axial spondyloarthritis (nr-axSpA) [4, 5]. Many rheumatologists and professional organizations, such as ASAS and Spondyloarthritis Research and Treatment Network (SPARTAN), consider AS and nr-axSpA to be part of one disease spectrum (axSpA) [6, 7]. Patients with nr-axSpA can sometimes progress to AS; not all patients with nr-axSpA progress to AS [8]. Progression from nr-axSpA to AS has been reported to occur in approximately 5% to 12% of patients after 2 years [9, 10] and approximately 25% of patients after 15 years [11]
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