Relationship between disease activity status or clinical response and patient-reported outcomes in patients with non-radiographic axial spondyloarthritis: 104-week results from the randomized controlled EMBARK study

Dougados, Maxime; Heijde, Desirée van der; Tsai, Wen‐Chan; Saaibi, Diego Luis; Marshall, L.; Jones, Heather; Pedersen, Ron; Vlahos, Bonnie; Tarallo, M.

doi:10.1186/s12955-019-1260-4

Cited by 10 publications

(9 citation statements)

References 11 publications

(15 reference statements)

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“…Moreover, the level of disease activity and functional ability also determine and correlate with the PRO results and quality of life. 11 , 42 – 45 …”

Section: Discussionmentioning

confidence: 99%

Delayed treatment with a tumor necrosis factor alpha blocker associated with worse outcomes in patients with spondyloarthritis: data from the Czech National Registry ATTRA

Milota

Hurňáková

Pavelka

et al. 2022

Therapeutic Advances in Musculoskeletal

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Introduction: The administration of biologic disease-modifying antirheumatic drugs, including tumor necrosis factor (TNF)-α inhibitors, is observed to interfere with the disease activity and progression. In this study, we aimed to assess the effectiveness and response predictors of adalimumab (ADA), a TNF-α blocker, in patients with axial spondyloarthritis (AxSpA). Methods: This study was a historical prospective, registry-based observational study on patients with AxSpA treated with first-line ADA after conventional drug failure. For evaluation and comparison, patients were divided into three groups according to the number of years from AxSpA diagnosis to initiation of ADA treatment: (A) <5 years, (B) 5–10 years, and (C) >10 years. The assessment instruments ankylosing spondylitis disease activity score (ASDAS), Bath ankylosing spondylitis activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), health assessment questionnaire (HAQ), Short Form 36 questionnaire (SF-36), and EuroQoL 5 dimension questionnaire (EQ-5D) were regularly administered for up to 24 months of follow-up. Results: This study included 1043 patients with AxSpA (9.2% with non-radiographic AxSpA, 68.9% men). By month 6, a significantly higher proportion of patients with ASDAS remission (<1.3) was achieved upon earlier intervention in group A (30.1%) and B (32.9%) than in the late intervention group C (22.6%) ( p ⩽ 0.05). At month 6, lower age and better BASFI at treatment initiation were identified as the strongest predictors of ASDAS remission in both univariable [odds ratio (OR): 0.956, p ⩽ 0.001; OR: 0.834, p ⩽ 0.001, respectively] and multivariable analyses (OR: 0.963, p ⩽ 0.001; OR: 0.859, p ⩽ 0.001, respectively). Earlier intervention also led to improvement in most patient-reported outcomes (PROs) based on HAQ, SF-36, and EQ-5D. Conclusion: Results from the ATTRA registry concur with previous clinical trials that supported efficacy of TNF-α blockers and showed better treatment outcomes with early interventions, including reduction of disease activity and improvement in PROs. We identified age and BASFI as the main factors influencing treatment effectiveness.

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“…Moreover, the level of disease activity and functional ability also determine and correlate with the PRO results and quality of life. 11 , 42 – 45 …”

Section: Discussionmentioning

confidence: 99%

Delayed treatment with a tumor necrosis factor alpha blocker associated with worse outcomes in patients with spondyloarthritis: data from the Czech National Registry ATTRA

Milota

Hurňáková

Pavelka

et al. 2022

Therapeutic Advances in Musculoskeletal

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“…Patients with AIDs should also be followed with clinical evaluation, laboratory test, QoL, tolerance, and treatment adherence. Relationships of patient-parent reported outcomes with disease activity have been studied in juvenile idiopathic arthritis (JIA) ( 20 – 26 ), juvenile idiopathic myositis ( 23 ), rheumatoid arthritis ( 27 – 29 ), systemic lupus erythematosus (SLE) ( 30 – 35 ), Behcet disease ( 36 ), and ankylosing spondylitis (AS) ( 34 , 37 ). The data on the relationship between disease activity and patient-parent reported outcomes in FMF are very limited.…”

Section: Discussionmentioning

confidence: 99%

Number of Episodes Can Be Used as a Disease Activity Measure in Familial Mediterranean Fever

et al. 2022

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ObjectiveTo evaluate the number of episodes in the past 12 months as an indicator of the overall disease activity status in Familial Mediterranean fever (FMF).MethodsIn this cross-sectional study, patients were recruited from tertiary pediatric hospitals. Demographic data, main clinical symptoms of the episodes, treatment modalities, and genetic mutations were recorded. The patients were grouped as no episodes (Group 1), 1–4 episodes (Group 2), and more than 4 episodes (Group 3) according to the number of episodes in the past 12 months. The Pediatric Quality Life Inventory (PedsQL), the Children’s Depression Inventory (CDI), and the Wong-Baker FACES Pain Rating Scale (FACES) scores were compared between groups. Concurrent validity between the number of episodes and the patient-reported outcome measures (PROMs) was assessed using Spearman’s rank correlation coefficient (ρ).ResultsA total of 239 patients were included. There were 74 patients (31%) in Group 1, 99 (41.4%) in Group 2, and 66 (27.6%) in Group 3. Groups were similar according to age, age at diagnosis, gender, consanguinity, family history, history of amyloidosis, clinical symptoms, and in terms of allele frequency (p > 0.05). According to PROMs completed by parents, moderate correlations were found between the number of episodes and the PedsQL score (ρ = −0.48; 95% CI = −0.58 to −0.35, p < 0.001) and between the number of episodes and the Wong-Baker FACES score (ρ = 0.47, 95% CI = 0.35–0.57, p < 0.001).ConclusionThe number of episodes was positively and moderately correlated with patient- and parent-reported outcomes in our cohort. The number of episodes in patients with FMF can be used as a single measure to assess disease activity.

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“…Composite scores including ASDAS and BASDAI are important elements for monitoring disease activity and treatment response (18). The BASDAI is based on 3 main concepts: pain (axial, peripheral, entheseal), fatigue and morning stiffness.…”

Section: Discussionmentioning

confidence: 99%

“…The last column corresponds to the mean (SD) score of each item with higher scores reflecting higher priority. 18…”

Section: Discussionmentioning

confidence: 99%

Exploring remission concept in axial spondyloarthritis through the perception of rheumatologists using vignettes and priority ratings

et al. 2021

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Objectives The optimal treatment target in axial spondyloarthritis (axSpA) is remission; however, a consensual definition of remission is lacking. Our objective was to explore rheumatologists’ perception of remission using vignette cases and a priority exercise. Methods A cross-sectional survey of rheumatologists’ perceptions of remission in axSpA was performed in 2020 using (a) 36 vignette cases, with a single clinical picture and 3 varying parameters (axial pain [ranging from 2 to 5 on a 0–10 scale], fatigue [2–8], and morning stiffness [<15 min, 30 min or 1 h], assessed as remission yes/no; (b) prioritization of elements to consider for remission from a list of 12 items: BASDAI, ASDAS, elements of BASDAI and ASDAS including CRP, NSAIDs use, extra-articular manifestations (EAMs), and other explanations of symptoms e.g. fibromyalgia. Analyses were descriptive. Results Overall, 200 French rheumatologists participated in 2,400 vignette evaluations. Of these, 463 (19%) were classified as remission. The 6 vignette cases representing 56% of all remission cases had <15 min duration of morning stiffness and axial pain ≤3/10, regardless of fatigue levels. Prioritized items for remission were: morning stiffness (75%), EAMs (75%), NSAID use (71%), axial pain (68%), and CRP (66%). Conclusions When conceptualizing remission in axSpA, rheumatologists took into account morning stiffness and axial pain as expected; the link between remission and fatigue was much weaker. Furthermore, rheumatologists also included EAMs and NSAID use in the concept of remission. Consensus is needed for definition of remission in axSpA.

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Relationship between disease activity status or clinical response and patient-reported outcomes in patients with non-radiographic axial spondyloarthritis: 104-week results from the randomized controlled EMBARK study

Cited by 10 publications

References 11 publications

Delayed treatment with a tumor necrosis factor alpha blocker associated with worse outcomes in patients with spondyloarthritis: data from the Czech National Registry ATTRA

Delayed treatment with a tumor necrosis factor alpha blocker associated with worse outcomes in patients with spondyloarthritis: data from the Czech National Registry ATTRA

Number of Episodes Can Be Used as a Disease Activity Measure in Familial Mediterranean Fever

Exploring remission concept in axial spondyloarthritis through the perception of rheumatologists using vignettes and priority ratings

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