The International Map of Axial Spondyloarthritis Survey: A <scp>US</scp> Patient Perspective on Diagnosis and Burden of Disease

Magrey, Marina; Walsh, Jessica A.; Flierl, Sandra; Howard, Richard A; Calheiros, Renato; Wei, Dennis; Khan, Muhammad Asim

doi:10.1002/acr2.11543

Cited by 6 publications

(2 citation statements)

References 43 publications

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“…We revealed AxSpA diagnostic delay of 5.5 years, with potentially adverse effects on patient outcomes. This delay is shorter than that reported by the broader European International Map of Axial Spondyloarthritis (IMAS) survey (7.4 years), where Poland was not represented [ 3 ], and by the US version of the IMAS survey (8.8 years) [ 12 ]. These differences in country-based diagnostic delays may be indicative of the efficiency of diverse healthcare management and patient education strategies.…”

Section: Discussionmentioning

confidence: 83%

Living with axial spondyloarthritis: a cross-sectional survey of patient knowledge and perceptions

Zimba,

Guła,

Strach

et al. 2024

Rheumatol Int

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Diagnosis and effective treatment of axial spondyloarthritis (AxSpA) are often delayed due to inadequate awareness and poor patient-physician communication. Some AxSpA patients fail to maintain an active lifestyle by exercising regularly, further worsening their disease management. The evolving concept of patient-centred care necessitates better understanding of patient awareness and their needs. We aimed to survey AxSpA patients to reflect on healthcare planning and management perspectives. Our self-administered questionnaire focused on perceptions of AxSpA diagnosis and management, particularly exploring issues of physical activity and active lifestyle. Satisfaction with AxSpA medical care and its accessibility, diagnostic delays, patient-physician communication, and support for disease management were also explored. This offline survey was arranged at the Department of Rheumatology, Immunology, and Internal Medicine of Jagiellonian University Medical College and Krakow University Hospital. We surveyed patients with AxSpA attending outpatient clinics between December 1st, 2023 and April 22nd, 2024. The questionnaire included questions on types of physical activities, barriers to exercising, satisfaction with medical care, patient-physician interactions, diagnostic delays, and use of teleconsultations. A total of 117 patients with AxSpA were enrolled (mean age 41.62 years). The majority (n = 93, 79.5%) were employed. There was a male predominance (69, 59%). The average diagnostic delay was 5.5 years. Notably, 104 (88.9%) responders perceived physical activity as a factor influencing their disease course. However, only 32 (27.35%) managed to exercise regularly (≥ 30 min, 2–3 times a week). The majority (70, 59.83%) were irregularly engaged in some form of physical activity, with 15 (12.8%) not exercising at all, and nearly half (48%) reported at least one barrier to maintaining a physically active lifestyle. Pain (32, 27.35%), fatigue (27, 23.08%), lack of motivation (17, 14.53%), and lack of time (12, 10.26%) were noted as barriers to exercising. The respondents preferred to exercise at home. The survey identified critical areas where patient dissatisfaction or uncertainty were notably prevalent: 38 (32.5%) were uncertain and 35 (30%) were dissatisfied with rehabilitation access. For spa therapy, 63 (53.85%) reported uncertainty and 23 (19.7%) expressed dissatisfaction. Only 48 (41%) were treated by a rehabilitation specialist last year. Only 23% of AxSpA patients took part in teleconsultations last year, and 65% preferred in-person visits. While AxSpA patients recognize the importance of physical activity, significant barriers exist to engaging them regularly in exercising. Addressing these barriers through personalized, motivational, and educational strategies could improve patient outcomes. Improving patient satisfaction with healthcare services, particularly in areas of rehabilitation and physician-patient communication, is crucial for improving the overall care of AxSpA patients.

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Section: Discussionmentioning

confidence: 83%

Living with axial spondyloarthritis: a cross-sectional survey of patient knowledge and perceptions

Zimba,

Guła,

Strach

et al. 2024

Rheumatol Int

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“…Patients with axSpA frequently have an elevated burden of disease with a significant reduction in their QoL attributed to chronic inflammation that leads to chronic pain, joint stiffness, structural damage, and reduced function in addition to fatigue (41,42). AxSpA has a pronounced impact on patients' daily lives, and several studies have shown that impaired functional disability is associated with axSpA (41,(43)(44)(45). In addition, the detrimental impact of axSpA on mental health (e.g., anxiety and depression) is also well documented (46-48).…”

Section: Burden Of Disease and Residual Disease In Axspamentioning

confidence: 99%

Pain in axial spondyloarthritis: role of the JAK/STAT pathway

Selmi,

Chimenti,

Novelli

et al. 2024

Front. Immunol.

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Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that is characterized by new bone formation in the axial musculoskeletal system, with X-ray discriminating between radiographic and non-radiographic forms. Current therapeutic options include non-steroidal anti-inflammatory drugs in addition to biological disease-modifying anti-rheumatic drugs that specifically target tumor necrosis factor-alpha (TNFα) or interleukin (IL)-17. Pain is the most critical symptom for axSpA patients, significantly contributing to the burden of disease and impacting daily life. While the inflammatory process exerts a major role in determining pain in the early phases of the disease, the symptom may also result from mechanical and neuromuscular causes that require complex, multi-faceted pharmacologic and non-pharmacologic treatment, especially in the later phases. In clinical practice, pain often persists and does not respond further despite the absence of inflammatory disease activity. Cytokines involved in axSpA pathogenesis interact directly/indirectly with the Janus kinase (JAK)/signal transducer and activator of transcription (STAT) signaling cascade, a fundamental component in the origin and development of spondyloarthropathies. The JAK/STAT pathway also plays an important role in nociception, and new-generation JAK inhibitors have demonstrated rapid pain relief. We provide a comprehensive review of the different pain types observed in axSpA and the potential role of JAK/STAT signaling in this context, with specific focus on data from preclinical studies and data from clinical trials with JAK inhibitors.

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Ixekizumab Treatment Patterns and Health Care Resource Utilization Among Patients with Axial Spondyloarthritis: A Retrospective United States Claims Database Study

Danve,

Vadhariya,

Lisse

et al. 2024

Rheumatol Ther

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Introduction Real-world data on ixekizumab utilization in axial spondyloarthritis (axSpA) are limited. We evaluated ixekizumab treatment patterns and health care resource utilization (HCRU) in patients with axSpA using United States Merative L.P. MarketScan ® Claims Databases. Methods This retrospective cohort study included adults with axSpA who initiated ixekizumab during the index period (September 2019–December 2021). Index date was the date of the first ixekizumab claim. All patients had continuous medical and pharmacy enrollment during the 12-month pre-index and follow-up periods. Descriptive statistics were used to assess patient demographics (index date); clinical characteristics (pre-index period); treatment patterns (12-month follow-up period); and HCRU (pre-index and 12-month follow-up periods). Results The study included 177 patients (mean age 45.8 years; females 54.8%) with axSpA who initiated ixekizumab. Overall, 79.1% of patients reported prior biologic use; of these, 70.7% received tumor necrosis factor-alpha inhibitors (TNFi) and 49% received secukinumab. The mean (standard deviation [SD]) Charlson Comorbidity Index score was 1.1 (1.3) and ~ 27% of patients reported ≥2 comorbidities. The median (inter-quartile range [IQR]) number of ixekizumab prescription refills was 7 (4–11). The mean (SD) Proportion of Days Covered (PDC) for ixekizumab was 0.6 (0.3) and adherence (PDC ≥80%) was 34.5% ( N = 61). Overall, 26.6% ( N = 47) of patients switched to a non-index medication and 54.2% ( N = 96) of patients discontinued ixekizumab. Among the patients who discontinued ixekizumab ( N = 96), 19.8% ( N = 19) restarted ixekizumab and 49.0% ( N = 47) switched to a non-index medication. The median (IQR) ixekizumab persistence was 268 (120–366) days. Mean axSpA-related outpatient, inpatient, and emergency room visits were similar between the pre-index and follow-up periods. Treatment patterns were largely similar between biologic-experienced patients ( N = 140; 79.1%) and the overall population. Conclusions Despite high comorbidity burden and majority of the patients being biologic-experienced, patients initiating ixekizumab for axSpA showed favorable persistence profiles during the 12-month follow-up period. Supplementary Information The online version contains supplementary material available at 10.1007/s40744-024-00710-0.

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The International Map of Axial Spondyloarthritis Survey: A US Patient Perspective on Diagnosis and Burden of Disease

Cited by 6 publications

References 43 publications

Living with axial spondyloarthritis: a cross-sectional survey of patient knowledge and perceptions

Living with axial spondyloarthritis: a cross-sectional survey of patient knowledge and perceptions

Pain in axial spondyloarthritis: role of the JAK/STAT pathway

Ixekizumab Treatment Patterns and Health Care Resource Utilization Among Patients with Axial Spondyloarthritis: A Retrospective United States Claims Database Study

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