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. 2020 Nov 21:12:1759720X20972610.
doi: 10.1177/1759720X20972610. eCollection 2020.

The impact of extra-musculoskeletal manifestations on disease activity, functional status, and treatment patterns in patients with axial spondyloarthritis: results from a nationwide population-based study

Imke Redeker  1 , Britta Siegmund  2 , Kamran Ghoreschi  3 , Uwe Pleyer  4 , Johanna Callhoff  5 , Falk Hoffmann  6 , Ursula Marschall  7 , Hildrun Haibel  2 , Joachim Sieper  2 , Angela Zink  5 , Denis Poddubnyy  5
Affiliations

The impact of extra-musculoskeletal manifestations on disease activity, functional status, and treatment patterns in patients with axial spondyloarthritis: results from a nationwide population-based study

Imke Redeker et al. Ther Adv Musculoskelet Dis. .

Abstract

Objective: The aim of this study was to investigate the association of extra-musculoskeletal manifestations (EMMs) with disease activity, functional status, and treatment patterns in a large population-based cohort of patients with axial spondyloarthritis (axSpA).

Methods: A stratified random sample of patients with axSpA, drawn from health insurance data, received a survey on disease-related characteristics including history (ever presence) of the following EMMs: inflammatory bowel disease (IBD), psoriasis (PSO), and anterior uveitis (AU). Survey data were linked to health insurance data, gathering additional information on current occurrence (within one year) of EMMs and drug prescriptions. Separate multivariable linear regression models were calculated to determine the association of EMMs with disease activity (Bath Ankylosing Spondylitis Disease Activity Index), and functional status (Bath Ankylosing Spondylitis Functional Index) after adjustment for relevant parameters, including treatment.

Results: A total of 1729 patients with axSpA were included in the analyses (response: 47%; mean age: 56 years; 46% female) of whom 6% (9%) had current (ever) IBD, 10% (15%) had current (ever) PSO, and 9% (27%) had current (ever) AU. Ever presence of IBD and history of PSO were significantly associated with higher level of disease activity. Ever presence of PSO was also associated with higher level of functional impairment, whereas current AU was significantly associated with lower disease activity. Patients with current IBD or PSO received more frequently biological and conventional synthetic disease-modifying anti-rheumatic drugs as well as systemic steroids. AU was associated with a higher use of conventional synthetic disease-modifying anti-rheumatic drugs only.

Conclusion: Disease activity is higher in patients with axSpA with history of IBD or history of PSO. Functional impairment is also higher in patients with axSpA with history of PSO. The presence of different EMMs was associated with different treatment patterns in axSpA.

Keywords: anterior uveitis; axial spondyloarthritis; disease activity; functional status; inflammatory bowel disease; psoriasis; treatment patterns.

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Conflict of interest statement

Conflict of interest statement: I. Redeker, J. Callhoff, F. Hoffmann, A. Zink declare no conflicts of interest. U. Marschall is an employee of BARMER. H. Haibel reports consulting fees or members of speakers’ bureau from AbbVie, Janssen, MSD, Novartis, Pfizer, and Roche. B. Siegmund, has served as a consultant for AbbVie, Boehringer, Celgene, Falk, Janssen, Lilly, Pfizer, Prometheus, Takeda and received speaker’s fees from AbbVie, CED Service GmbH, Falk, Ferring, Janssen, Novartis, Takeda (BS served as representative of the Charité). J. Sieper reports consulting fees or members of speakers’ bureau from AbbVie, Janssen, Lilly, MSD, Novartis, and Pfizer and grants from AbbVie, MSD, and Pfizer. D. Poddubnyy reports consulting fees or members of speaker’s bureau from AbbVie, BMS, Celgene, Lilly, MSD, Novartis, Pfizer, Roche, and UCB and grants from AbbVie, MSD, Novartis and Pfizer.

Figures

Figure 1.
Figure 1.
Prevalence of inflammatory bowel disease, psoriasis, and anterior uveitis in patients with axial spondyloarthritis (n = 1729).
See this image and copyright information in PMC

References

    1. Rudwaleit M, van der Heijde D, Landewe R, et al. The development of assessment of spondyloarthritis international society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis 2009; 68: 777–783. - PubMed
    1. Sieper J, Poddubnyy D. Axial spondyloarthritis. Lancet 2017; 390: 73–84. - PubMed
    1. de Winter JJ, van Mens LJ, van der Heijde D, et al. Prevalence of peripheral and extra-articular disease in ankylosing spondylitis versus non-radiographic axial spondyloarthritis: a meta-analysis. Arthritis Res Ther 2016; 18: 196. - PMC - PubMed
    1. Wendling D, Guillot X, Prati C, et al. Effect of gut involvement in patients with high probability of early spondyloarthritis: data from the DESIR cohort. J Rheumatol. Epub ahead of print 1 June 2019. DOI: 10.3899/jrheum.181326. - DOI - PubMed
    1. Essers I, Ramiro S, Stolwijk C, et al. Do extra-articular manifestations influence outcome in ankylosing spondylitis? 12-year results from OASIS. Clin Exp Rheumatol 2016; 34: 214–221. - PubMed