Background/Purpose: Spondyloarthritis (SpA) is a group of chronic, inflammatory diseases associated with severe pain in the joints and entheses. There is limited evidence on real-world disease burden and treatment patterns in the overall SpA population, as well as individual SpA conditions. This study surveyed self-reported burden of disease and medication use in US patients with SpA in a real-world setting.

Methods: Descriptive data on demographics, disease definition and history, and medication were collected from a random sample of patients with SpA associated with the Spondylitis Association of America (SAA). Between July 7 and August 31, 2017, 820 interviews were conducted with SAA contacts, including 720 completed via Web survey (from 7750 emails) and 100 via follow-up over the phone (from 10,784 phone calls made to 5000 unique numbers). All 820 participants self-reported receiving a diagnosis of SpA from their doctor and were included in this study.

Results: The mean age of the 820 respondents was 55.1 years, and 44.3% were male. The most common self-reported SpA disease was ankylosing spondylitis (AS; 87.3%), followed by uveitis/iritis (28.3%). The most frequently reported comorbidities were high blood pressure (34.8%), high cholesterol (26.5%), and depression (23.4%). Compared with women, men were more impacted by high blood pressure (42.7% vs 28.5%) and heart disease (14.0% vs 4.0%), and less impacted by fibromyalgia (4.2% vs 22.1%). Acid reflux (50.7%) and eye inflammation (45.2%) were also common issues experienced among respondents. On average, respondents with AS first noticed disease symptoms 26.6 years ago, and received an AS diagnosis ≈ 8.2 years later. Respondents saw an average of 2.2 doctors about their back pain, joint pain, or inflammatory problems within the last 2 years, including 20.7% of respondents who saw ≥ 4 doctors. Regarding treatment, 76.7% of respondents with AS received care from rheumatologists, 8.7% from primary care physicians, and 3.8% from orthopedic surgeons; 57.5% of respondents with AS discussed medication options with their doctor and jointly participated in treatment decisions. Prior and current medications are shown in Table 1. More than one-half of respondents (54.4%) were at least mostly satisfied with their current treatment. Many respondents also applied non-medicinal treatment to their lifestyle, including stretching and strengthening exercises (66.2%); biking, running, or walking (57.4%); practicing proper posture techniques (56.5%); and special diets (39.4%).

Conclusion: In this real-world survey, most respondents reported substantial delays in diagnosis of AS, received care from rheumatologists, and participated in making treatment decisions. Many respondents indicated making lifestyle modifications in addition to using pharmacologic treatment. These data provide valuable insight into patient-reported disease burden and treatment profile of US patients with SpA.