Residual Disease Activity and Burden of Disease in Canadian Patients With Axial Spondyloarthritis: Results From a Multiregistry Analysis (UNISON-Axial SpA)

Denis Choquette¹, Dafna D Gladman², Robert D Inman³, Proton Rahman⁴, Marie-Claude Laliberté⁵, Pierre-André Fournier⁶, Tanya Girard⁷, Stephanie Wichuk⁸, Louis Coupal⁹, Vinod Chandran¹⁰, Sherry Rohekar¹¹, Tristan Boyd¹², Michel Zummer¹³, Nicolas Richard¹⁴, Carter Thorne¹⁵, Dianne Mosher¹⁶, Olga Ziouzina¹⁷, Alexander Tsoukas¹⁸, Michael Starr¹⁹, Jonathan Chan²⁰, Sibel Zehra Aydin²¹, Walter P Maksymowych²²

Affiliations

¹ D. Choquette, MD, Institut de Rhumatologie de Montréal, CHUM, University of Montréal, Montreal, Quebec.
² D.D. Gladman, MD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Institute of Medical Science, Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, and Gladman-Krembil Psoriatic Arthritis Program, University Health Network, Centre for Prognosis Studies in The Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario.
³ R.D. Inman, MD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Institute of Medical Science, Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario.
⁴ P. Rahman, MD, Department of Medicine, Memorial University of Newfoundland, Newfoundland and Labrador.
⁵ M.C. Laliberté, PhD, AbbVie Corporation, St. Laurent, Quebec.
⁶ P.A. Fournier, MSc, MBA, AbbVie Corporation, St. Laurent, Quebec.
⁷ T. Girard, PhD, AbbVie Corporation, St. Laurent, Quebec.
⁸ S. Wichuk, MSc, Department of Medicine, University of Alberta, Edmonton, Alberta.
⁹ L. Coupal, MSc, Institut de Rhumatologie de Montréal, CHUM, University of Montréal, Montreal, Quebec.
¹⁰ V. Chandran, MBBS, MD, DM, PhD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Institute of Medical Science, Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, and Gladman-Krembil Psoriatic Arthritis Program, University Health Network, Centre for Prognosis Studies in The Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario.
¹¹ S. Rohekar, MD, University of Western Ontario, St. Joseph's Healthcare, London, Ontario.
¹² T. Boyd, MD, University of Western Ontario, St. Joseph's Healthcare, London, Ontario.
¹³ M. Zummer, MD, Hôpital Maisonneuve Rosemont, Université de Montréal, Montreal, Quebec.
¹⁴ N. Richard, MD, Hôpital Maisonneuve Rosemont, Université de Montréal, Montreal, Quebec.
¹⁵ C. Thorne, MD, University of Toronto, The Arthritis Program Research Group Inc., Newmarket, Ontario.
¹⁶ D. Mosher, MD, University of Calgary, Calgary, Alberta.
¹⁷ O. Ziouzina, MD, University of Calgary, Calgary, Alberta.
¹⁸ A. Tsoukas, MD, McGill University Health Science Center, Montréal, Québec.
¹⁹ M. Starr, MD, McGill University Health Science Center, Montréal, Québec.
²⁰ J. Chan, MD, ARTUS Health Centre, Vancouver, British Columbia.
²¹ S.Z. Aydin, MD, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Ontario.
²² W.P. Maksymowych, MB ChB, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

PMID: 40592555
DOI: 10.3899/jrheum.2024-1303

Free article

Residual Disease Activity and Burden of Disease in Canadian Patients With Axial Spondyloarthritis: Results From a Multiregistry Analysis (UNISON-Axial SpA)

Denis Choquette et al. J Rheumatol. 2025.

Free article

. 2025 Aug 1:jrheum.2024-1303.

doi: 10.3899/jrheum.2024-1303. Online ahead of print.

Authors

Affiliations

¹ D. Choquette, MD, Institut de Rhumatologie de Montréal, CHUM, University of Montréal, Montreal, Quebec.
² D.D. Gladman, MD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Institute of Medical Science, Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, and Gladman-Krembil Psoriatic Arthritis Program, University Health Network, Centre for Prognosis Studies in The Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario.
³ R.D. Inman, MD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Institute of Medical Science, Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario.
⁴ P. Rahman, MD, Department of Medicine, Memorial University of Newfoundland, Newfoundland and Labrador.
⁵ M.C. Laliberté, PhD, AbbVie Corporation, St. Laurent, Quebec.
⁶ P.A. Fournier, MSc, MBA, AbbVie Corporation, St. Laurent, Quebec.
⁷ T. Girard, PhD, AbbVie Corporation, St. Laurent, Quebec.
⁸ S. Wichuk, MSc, Department of Medicine, University of Alberta, Edmonton, Alberta.
⁹ L. Coupal, MSc, Institut de Rhumatologie de Montréal, CHUM, University of Montréal, Montreal, Quebec.
¹⁰ V. Chandran, MBBS, MD, DM, PhD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Institute of Medical Science, Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, and Gladman-Krembil Psoriatic Arthritis Program, University Health Network, Centre for Prognosis Studies in The Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario.
¹¹ S. Rohekar, MD, University of Western Ontario, St. Joseph's Healthcare, London, Ontario.
¹² T. Boyd, MD, University of Western Ontario, St. Joseph's Healthcare, London, Ontario.
¹³ M. Zummer, MD, Hôpital Maisonneuve Rosemont, Université de Montréal, Montreal, Quebec.
¹⁴ N. Richard, MD, Hôpital Maisonneuve Rosemont, Université de Montréal, Montreal, Quebec.
¹⁵ C. Thorne, MD, University of Toronto, The Arthritis Program Research Group Inc., Newmarket, Ontario.
¹⁶ D. Mosher, MD, University of Calgary, Calgary, Alberta.
¹⁷ O. Ziouzina, MD, University of Calgary, Calgary, Alberta.
¹⁸ A. Tsoukas, MD, McGill University Health Science Center, Montréal, Québec.
¹⁹ M. Starr, MD, McGill University Health Science Center, Montréal, Québec.
²⁰ J. Chan, MD, ARTUS Health Centre, Vancouver, British Columbia.
²¹ S.Z. Aydin, MD, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Ontario.
²² W.P. Maksymowych, MB ChB, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

PMID: 40592555
DOI: 10.3899/jrheum.2024-1303

Abstract

Objective: There is a key knowledge gap in quantifying residual disease activity in Canadian patients with axial spondyloarthritis (axSpA). The objective of this study was to evaluate and describe residual disease activity and burden of disease in Canadian patients with axSpA.

Methods: This was an observational, retrospective analysis of data extracted from the Rhumadata (Québec), Spondyloarthritis Research Consortium of Canada (SPARCC; East/Atlantic and West regions, as well as Ontario), and Follow-up Research Cohort of Ankylosing Spondylitis (FORCAST; Alberta) registries. The primary endpoint was the proportion of patients who failed to achieve sustained low disease activity (LDA) at 12 months. LDA was defined as a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score < 3 and sustained LDA was defined as achieving LDA at both 6 and 12 months after the most recent change in treatment. Analyses included outcomes by treatment class (nonsteroidal antiinflammatory drugs, tumor necrosis factor inhibitor, or interleukin 17 inhibitor).

Results: A total of 980 patients (Rhumadata, N = 488; SPARCC, N = 239; FORCAST, N = 253) were included. Nearly half of patients with axSpA from Rhumadata (49.5%) and FORCAST (55.3%) and 65.8% of those from SPARCC failed to achieve LDA (BASDAI < 3) at 6 months after treatment initiation. At 12 months, failure to achieve sustained LDA rose to 62% in Rhumadata, 65.1% in FORCAST, and 81% in SPARCC. Pain persisted in nearly half of all patients.

Conclusion: This analysis demonstrated that most Canadians with axSpA failed to achieve sustained LDA after 12 months of initiating their latest therapy and confirms a high unmet need for additional treatments.

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Residual Disease Activity and Burden of Disease in Canadian Patients With Axial Spondyloarthritis: Results From a Multiregistry Analysis (UNISON-Axial SpA)

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Residual Disease Activity and Burden of Disease in Canadian Patients With Axial Spondyloarthritis: Results From a Multiregistry Analysis (UNISON-Axial SpA)

Authors

Affiliations

Abstract

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Research Materials

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