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Study shows similarities between ankylosing spondylitis, non-radiographic axial spondyloarthritis

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A multi-country prospective observational study showed patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis had comparable clinical features and disease burden and experienced a long delay in referral to rheumatologists.

“Patients with ankylosing spondylitis (AS) and non-radiographic axial [spondyloarthritis] SpA (nr-axSpA), as classified by Assessment of Spondyloarthritis International Society (ASAS) criteria, have comparable disease activity and burden,” Robert D. Inman, MD, of the University of Toronto, Canada, told Healio.com/Rheumatology. “Delays in diagnosis were mainly due to delays in referrals to rheumatologists.”

Inman and colleagues identified 2,084 patients with AS. Of these patients, 60% had AS and 40% had nr-axSpA. At yearly follow-up visits, researchers assessed disease activity, physical function, quality of life, productivity and pelvic X-rays.

Investigators found 85% of patients had human leukocyte antigen-B27 tested and results showed 68% of these patients had a positive human leukocyte antigen-B27. According to results, patients were in their mid-30s, had a long delay in referral to a rheumatologist and were recently diagnosed with axial spondyloarthritis.

Within 6 months of the baseline visit, 1,635 patients underwent pelvic X-rays and researchers noted 1,344 of these patients had X-rays scored by both local and central readers. After central reading, results showed 83.3% of the 1,344 patients retained their classification of AS or nr-axSpA vs. 16.7% of patients who received a different classification. Researchers found substantial agreement on the grading of X-rays between local and central readers, according to kappa value.

“Although there were some numerical differences between AS and nr-axSpA patients in bath ankylosing spondylitis disease activity index (BASDAI) (higher in nr-axSpA) and ankylosing spondylitis disease activity score containing C-reactive protein (ASDAS-CRP) (higher in AS), those were not considered clinically meaningful,” Inman said. “Higher ASDAS-CRP in AS patients was owing to higher levels of CRP as a laboratory marker of inflammation. Comparable clinical disease activity and burden in this large cohort of patients in rheumatology clinical practice reinforces the need for a similar treatment approach in AS and nr-axSpA patients.” – by Casey Tingle

Reference:

Inman RD, et al. Abstract #THU0407. Presented at: EULAR Annual Congress; June 8-11, 2016; London.

Disclosures: Inman received grant or research support from, is a consultant for and is on the speakers bureau of AbbVie, Amgen, Janssen, Pfizer and UCB. Please see the full abstract for a list of all other authors’ relevant financial disclosures.