Patient Burden of Axial Spondyloarthritis

Abstract

Axial spondyloarthritis (AxSpA) is an inflammatory spondyloarthritis (SpA) that has significant impact on a patient's life. Symptoms, including fatigue, sleep problems, depression, and sexual dysfunction, can profoundly impact health-related quality of life (HRQoL) and limit work, leisure, and daily activities. Available therapies effectively manage pain and inflammation in early-stage disease, but patients often continue to experience impaired HRQoL. Thus, there remains a need for new therapies with novel mechanisms that can stop disease progression, potentially reverse damage caused by AxSpA and improve HRQoL in patients with AxSpA. Newer biologic agents, such as those targeting the interleukin 17-interleukin 23 axis, have promising efficacy and may improve HRQoL for patients with AxSpA. The AxSpA has many negative effects on HRQoL. By targeting disease pathways responsible for the development of AxSpA, approved and emerging therapies potentially reduce disease activity and improve the functional status of patients with AxSpA. This narrative review reflects on the findings of studies evaluating HRQoL of individuals with AxSpA and the role of newer therapies.

FIGURE

Health-related quality-of-life outcomes from phase 3 trials of newer targeted agents for treatment of AxSpA. Patients receiving placebo were randomized to secukinumab at week 16. Intravenous secukinumab (10 mg/kg) or placebo was given at weeks 0, 2, and 4 followed by subcutaneous secukinumab (150 or 75 mg) or placebo every 4 weeks starting at week 8. Note: For Short Form-36 summary component scores, an increase of 2.5 to 5.0 points has been used as the MCID in SpA. Short Form-36 summary component scores are transformed into a 100-point scale for which 0 is maximum disability and 100 is no disability. For ASQoL, a decrease of 2.0 or more points has been used as the MCID in AxSpA. Scores on the ASQoL scale range from 0 (best quality) to 18 (poorest quality). *P < 0.001 versus placebo. ^†P < 0.01 versus placebo. Error bars are +/- standard error.