Background/Purpose: Several studies demonstrate efficacy of biologics on disease activity measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in patients with axial spondyloarthritides (AxSpA). The Bath Ankylosing Spondylitis Metrology Index (BASMI) is a measure of spinal and hip mobility using 5 domains. To our knowledge no studies have specifically looked at the impact of biologics on BASMI. The aim of our study was to assess if biologics appear to have an effect on BASMI.

Methods: We retrospectively collected the data from a cohort of patients with AxSpA reviewed within a designated clinic in the North West of England who were treated for at least 12 months with a biologic . BASMI scores were recorded at pre biologic, 3 month and 12 month follow up.

Results: Data from 68 patients were analysed (57 AS, 7 PsA, 4 enteropathic arthritis). 58 (85.3%) were male; median age was 52 years (IQR 43,61) Overall 63/68 patients (92.6%) were treated with TNF-inhibitors – including etanercept n=25 (originator or biosimilar), adalimumab n=31, golimumab n=5, infliximab n=2 , 5/68 patients (7.4%) were treated with secukinumab. Median BASMI at baseline was 4.55 (IQR 2.7,6.05). Improvements of BASMI scores were demonstrated with a reduction to a median BASMI of 3.6 (IQR 2,5) at 3 months and 3 (IQR 1.7, 5.2) at 12 months. Improvement appeared to be independent of age. There was no difference identified in improvement between TNF and IL-17 drugs.

Conclusion: Biologics drugs appeared to improve BASMI scores in our cohort through a 12 month period. Due to the small cohort we were unable to highlight any differences between patients treated with aTNF and IL-17 inhibitor medication. Multiple factors can be associated with BASMI changes including motivation, disease duration and progression, use or non use of NSAIDs, exercise behaviours, gender (women may be more flexible in the lumbar spine than men due to less radiographic changes in the hips, lumbar spine and sacroiliac joints (3 BASMI domains) but may have more progression in the neck and upper thoracic spine (2 BASMI domains). We know there is variance in exercise behaviours in that when some feel better they don’t perceive the need to physiotherapy exercise so much and therefore don’t, but may be more likely to participate in a more active lifestyle and others who are more motivated to do their exercise therapies. We also know that other factors such as anxiety and depression also have a bearing on exercise behaviours and are likely to be related to how they would rate on BASMI and Bath Ankylosing Spondylitis Functional Index (BASFI) scoring. Unfortunately some of the above aspects are difficult to measure but we are planning to further analyse our data inclusive of disease duration prior to commencement of biologics and correlation between BASDAI and BASMI and radiological progressions.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/correlation-between-biologics-and-bath-ankylosing-spondylitis-metrology-index-within-the-first-12-months-of-treatment-in-patients-with-axial-spondyloarthritis/