Comparing Symptoms, Treatments Patterns, and Quality of Life of Non-radiographic Axial Spondyloarthritis and Ankylosing Spondylitis Patients: Findings from a US Survey

Theresa Hunter¹, David Sandoval ², Nicola Booth ³, Elizabeth Holdsworth ⁴ and Atul Deodhar ⁵, ¹Eli Lilly and Company, Indianapolis, ²Eli Lilly and Company, Indianapolis, IN, ³Adelphi Real World, Bollington, United Kingdom, ⁴Adelphi Real World, Manchester, England, United Kingdom, ⁵Oregon Health & Science University, Portland, OR

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: axial spondyloarthritis, non-radiographic and ankylosing spondylitis (AS), quality of life, treatment

Session Information

Date: Sunday, November 10, 2019

Session Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster I: Axial Spondyloarthritis, Clinical Features

Session Type: Poster Session (Sunday)

Session Time: 9:00AM-11:00AM

Background/Purpose: To better understand the symptoms, clinical characteristics, treatment patterns, and quality of life (QoL), of non-radiographic axial spondyloarthritis (nr-axSpA) patients and how they compare to ankylosing spondylitis (AS) patients.

Methods: Data from a cross-sectional survey conducted with rheumatologists and their consulting patients in the United States were analyzed. Data were collected from Jun-Aug 2018 via physician-completed patient record forms and patient self-completed forms. Patients who had physician confirmed diagnoses of AS and nr-axSpA were eligible to participate. Demographics, disease status (improving, stable, deteriorating slowly, deteriorating rapidly), symptoms, and medication use were reported by the physician, while work disability and QoL measures were reported by the patient using validated questionnaires. QoL and treatment patterns of nr-axSpA and AS patients were compared using parametric tests and non-parametric tests where appropriate.

Results: Data from 88 rheumatologists, 515 AS patients, and 495 nr-axSpA patients were included in this analysis. A higher proportion of nr-axSpA patients were female (46.7% vs. 28.7%; p< 0.0001) and had a younger mean age (44.2 vs. 46.3; p=0.014) compared to AS patients. Nr-axSpA patients were less likely to be prescribed biologic therapy (59.6% vs. 73.6%; p< 0.0001) than AS patients. On average, AS patients experienced slightly more symptoms at diagnosis (2.31 vs. 2.61; p=0.023), however, more nr-axSpA patients were reported to experience enthesitis (24.9% vs. 19.3%; p=0.048) and synovitis (20.6% vs. 13.1%; p=0.003). Patient reported outcomes such as the Assessment of SpondyloArthritis international Society Health Index (ASAS HI;5.24 vs. 5.74; p=0.171), Ankylosing Spondylitis Quality of Life (ASQoL; 5.81 vs. 6.29; p=0.296), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; 2.92 vs. 3.19; p=0.124), and Work Productivity and Activity Impairment (WPAI; 27.6 vs. 30.2; p=0.183) were similar between nr-axSpA and AS patients.

Conclusion: Nr-axSpA and AS being part of the same disease spectrum (i.e. axial spondyloarthritis) share the same clinical features. The burden of the disease, as assessed by QoL measurements, is also similar in AS and nr-axSpA patients, but despite these similarities, patients with nr-axSpA are less likely to be treated with a biologic. The treatment approach for nr-axSpA needs to be similar to AS.

Disclosure: T. Hunter, Eli Lilly, 1, 3, Eli Lilly and Company, 1, 3; D. Sandoval, Eli Lilly, 1, 3, Eli Lilly and Company, 1, 3; N. Booth, Adelphi Real World, 3; E. Holdsworth, None; A. Deodhar, AbbVie, 2, 5, 9, Abbvie, 5, 8, Abbvie, Amgen, Boehringer Ingelheim, BMS, Eli Lilly, GlaxoSmithKline, Janssen, Novartis AG, Pfizer, and UCB Pharma, 5, 8, AbbVie, Amgen, Boehringer Ingelheim, BMS, Eli Lilly, GSK, Galapagos, Janssen, Novartis, Pfizer and UCB, 5, AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Glaxo Smith and Klein, Janssen, Novartis, Pfizer, UCB, 5, Amgen, 5, 8, 9, BMS, 2, 5, 8, BMS, Eli Lilly, Glaxo Smith & Kline, Janssen, Novartis, Pfizer, UCB, 2, BMS, Eli Lilly, GlaxoSmithKline, Janssen, Novartis AG, Pfizer, UCB Pharma, 2, Boehringer Ingelheim, 5, 8, Boehringer-Ingelheim, 5, 8, Bristol Myers Squibb, 2, 5, Bristol-Myers Squibb, 2, 5, 8, Eli Lilly, 2, 5, 8, 9, Eli Lilly and Company, 2, 5, Eli Lilly,, 5, Eli Lilly, GSK, Novartis, Pfizer and UCB, 2, Galagagos, 5, Galapagos, 5, 8, 9, Glaxo Smith & Klein, 2, Glaxo Smith & Kline, 2, 5, 8, Glaxo Smith Klein, 5, Glaxo SmithKlein, 2, 5, GlaxoSmithKlein, 2, 5, GlaxoSmithKline, 2, 5, 8, GSK, 2, 5, Janssen, 2, 5, 8, 9, Janssen Pharmaceutica, 2, 5, Janssen Research & Development, LLC, 2, Lilly, 2, 5, Novartis, 2, 5, 8, 9, Pfizer, 2, 5, 8, 9, UCB, 2, 5, 8, 9.

To cite this abstract in AMA style:

Hunter T, Sandoval D, Booth N, Holdsworth E, Deodhar A. Comparing Symptoms, Treatments Patterns, and Quality of Life of Non-radiographic Axial Spondyloarthritis and Ankylosing Spondylitis Patients: Findings from a US Survey [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/comparing-symptoms-treatments-patterns-and-quality-of-life-of-non-radiographic-axial-spondyloarthritis-and-ankylosing-spondylitis-patients-findings-from-a-us-survey/. Accessed August 12, 2020.

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