Ciurea, Adrian; Götschi, Andrea; Bräm, René; Bürki, Kristina; Exer, Pascale; Andor, Michael; Nissen, Michael J; Möller, Burkhard; Hügle, Thomas; Rubbert-Roth, Andrea; Kyburz, Diego; Distler, Oliver; Scherer, Almut; Micheroli, Raphael (2023). Early axial spondyloarthritis according to the ASAS consensus definition: characterisation of patients and effectiveness of a first TNF inhibitor in a large observational registry. RMD open, 9(4) BMJ Publishing Group 10.1136/rmdopen-2023-003455
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OBJECTIVE
To characterise the population fulfilling the Assessment of SpondyloArthritis international Society (ASAS) consensus definition of early axial spondyloarthritis (axSpA) and to determine the effectiveness of a first tumour necrosis factor inhibitor (TNFi) in early versus established axSpA in a large observational registry.
METHODS
A total of 3064 patients with axSpA in the Swiss Clinical Quality Management registry with data on duration of axial symptoms were included (≤2 years=early axSpA, N=658; >2 years=established axSpA, N=2406). Drug retention was analysed in patients starting a first TNFi in early axSpA (N=250) versus established axSpA (N=874) with multiple-adjusted Cox proportional hazards models. Adjusted logistic regression analyses were used to determine the achievement of the ASAS criteria for 40% improvement (ASAS40) at 1 year.
RESULTS
Sex distribution, disease activity, impairments of function and health-related quality of life were comparable between patients with early and established axSpA. Patients with established disease were older, had more prevalent axial radiographical damage and had a higher impairment of mobility. A comparable TNFi retention was found in early versus established disease after adjustment for age, sex, human leucocyte antigen-B27 status, education, body mass index, smoking, elevated C reactive protein and sacroiliac inflammation on MRI (HR 1.05, 95% CI 0.78 to 1.42). The adjusted ASAS40 response was similar in the two groups (OR 1.09, 95% CI 0.67 to 1.78). Results were confirmed in the population fulfilling the ASAS classification criteria.
CONCLUSION
Considering the recent ASAS definition of early axSpA, TNFi effectiveness seems comparable in early versus established disease.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology and Immunology |
UniBE Contributor: |
Möller, Burkhard |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2056-5933 |
Publisher: |
BMJ Publishing Group |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
06 Dec 2023 15:26 |
Last Modified: |
06 Dec 2023 22:24 |
Publisher DOI: |
10.1136/rmdopen-2023-003455 |
PubMed ID: |
38053462 |
Uncontrolled Keywords: |
Epidemiology Spondylitis, Ankylosing Tumor Necrosis Factor Inhibitors |
BORIS DOI: |
10.48350/189890 |
URI: |
https://boris.unibe.ch/id/eprint/189890 |
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