Response to: Correspondence on "ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update" by Ramiro<i>et al</i>

Smolen, Josef S; Nikiphorou, Elena; Sepriano, Alexandre; Ortolan, Augusta; Webers, Casper; Baraliakos, Xenofon; Landewé, Robert; Heijde, Desirée van der

doi:10.1136/ard-2023-223937

Cited by 106 publications

(164 citation statements)

References 10 publications

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“… 45–48 Rehabilitation programmes are an effective way to provide patients with axSpA the access to healthcare professionals, which may improve participation. 47 49 …”

Section: Discussionmentioning

confidence: 99%

“…44 Specialised rheumatological rehabilitation programmes use a multidisciplinary approach to address the different individual needs of patients, including education and provision of self-management strategies which are addressed by recommendations. [45][46][47][48] Rehabilitation programmes are an effective way to provide patients with axSpA the access to healthcare professionals, which may improve participation. 47 49 Some studies show that various demographic variables such as age, sex and education are also associated with WP, 6 9 35 50 although not consistently.…”

Section: Spondyloarthritis Spondyloarthritis Spondyloarthritismentioning

confidence: 99%

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Work participation in patients with axial spondyloarthritis: high prevalence of negative workplace experiences and long-term work impairment

Kiltz

Hoeper

Hammel³

et al. 2023

RMD Open

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IntroductionAxial spondyloarthritis (axSpA) is a chronic inflammatory disease that typically affects people in their second and third decades of life, which are important years for establishing a professional career. We aim to study outcomes of work participation (WP) and their associations with demographic and clinical confounders, in addition to prevalence of negative workplace experiences in axSpA.MethodsIn total, 770 patients with axSpA participated in the multicentre, observational ATTENTUS–axSpA survey in Germany. Demographic information, clinical parameters and patient-related outcomes (including disease activity and function) with a focus on WP were prospectively recorded.ResultsA high prevalence of negative workplace experiences was reported among the 770 patients analysed. Overall, 23.4% of patients were not employed and 6.5% received disability pensions. Current work cessation was prevalent in 120 patients, and 28 of those were out of work for 10 years or longer. Of the 590 currently employed patients, 31.9% reported absenteeism and 35.9% reported presenteeism for >1 month within the past year. Multivariate logistic regression identified low disease activity (Bath Ankylosing Spondylitis Disease Activity Index), better physical function (Bath Ankylosing Spondylitis Functional Index) and better global functioning (Assessment of SpondylAarthritis International Society–Health Index) as the main predictors for unimpaired WP (n=242). Importantly, biological treatment, disease duration, age, sex, education level and body mass index were not reliable predictors.DiscussionDespite improvements in pharmacological treatment options, we still observed substantially impaired WP in patients with axSpA. These data emphasise the high unmet need for targeted strategies to provide improved medical and social care.

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“… 45–48 Rehabilitation programmes are an effective way to provide patients with axSpA the access to healthcare professionals, which may improve participation. 47 49 …”

Section: Discussionmentioning

confidence: 99%

Section: Spondyloarthritis Spondyloarthritis Spondyloarthritismentioning

confidence: 99%

Work participation in patients with axial spondyloarthritis: high prevalence of negative workplace experiences and long-term work impairment

Kiltz

Hoeper

Hammel³

et al. 2023

RMD Open

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“…It is important to mention that there are very few interventional studies addressing patients with axial PsA; therefore, the evidence and guidelines in primary axSpA [36] also play a role in axial PsA.…”

Section: What Is the Optimal Treatment Approach In Patients With Conf...mentioning

confidence: 99%

Managing Psoriatic Arthritis Patients Presenting with Axial Symptoms

Poddubnyy

2023

Drugs

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Axial symptoms (i.e., back pain) are common in the general population. At the same time 25-70% of patients with psoriatic arthritis (PsA) exhibit signs of inflammatory axial involvement (axial PsA). The presence of unexplained chronic (duration ≥ 3 months) back pain in a patient with psoriasis or PsA should trigger evaluation of the presence of axial involvement. Evaluation of axial involvement normally involves imaging of the axial skeleton (sacroiliac joints and/or spine) in addition to clinical and laboratory evaluation. Symptomatic patients with confirmed axial PsA are treated with a combination of nonpharmacologic and pharmacologic methods including the use of non-steroidal anti-inflammatory drugs, tumour necrosis factor, interleukin 17, and Janus kinase inhibitors. Interleukin 23 blockade might also be effective in the axial domain of PsA; a dedicated clinical study is ongoing at present. Safety considerations, patient preference, as well as the presence of other disease manifestations (especially of extra-musculoskeletal manifestations-clinically relevant psoriasis, acute anterior uveitis, inflammatory bowel disease), define the choice of a specific drug or drug class. Key PointsAxial symptoms (first of all, chronic back pain) in patients with psoriasis/psoriatic arthritis, especially if started at young age should raise a suspicion of the presence of axial involvement.The diagnostic evaluation of axial symptoms should normally include imaging for the detection of active inflammatory and structural changes indicative of axial involvement.Symptomatic patients with confirmed axial involvement should be treated with a combination of nonpharmacologic and pharmacologic methods including the use of non-steroidal anti-inflammatory drugs, tumour necrosis factor, interleukin 17, and Janus kinase inhibitors.

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“…Several clinical trials have demonstrated the efficacy of bDMARDs in improving the key clinical efficacy outcomes among patients with nr-axSpA [11][12][13][14][15][16][17]. One such bDMARD is certolizumab pegol (CZP), a PEGylated, Fc-free TNFi, which has shown a positive risk/benefit profile in adult patients with axSpA, with inadequate response to conventional therapy, and has subsequently been approved for the treatment of axSpA in Europe and North America [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Biologic Disease-Modifying Anti-Rheumatic Drugs for Non-Radiographic Axial Spondyloarthritis: A Systematic Literature Review and Bucher Indirect Comparisons

Akkoç

Arteaga²,

Auteri³

et al. 2023

Rheumatol Ther

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Introduction: Biologic disease-modifying antirheumatic drugs (bDMARDs), including certolizumab pegol (CZP), are effective treatment options for the management of non-radiographic spondyloarthritis (nr-axSpA). In the absence of head-to-head comparisons in nr-axSpA, we conducted a systematic literature review (SLR) and indirect treatment comparison (ITC) to better understand the comparative efficacy of CZP vs. other bDMARDs. Methods: Literature searches were conducted in October 2020 in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials in patients with nr-axSpA who had failed at least one non-steroidal anti-inflammatory drug and were treated with bDMARDs. Outcomes of interest included the Assessment of Spondyloarthritis international Society (ASAS), Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Functional Index (BASFI) and Disease Activity Index (BASDAI), and spinal pain score. Comparative efficacy was examined using a series of Bucher ITCs in subgroups matched by prior exposure to bDMARDs, disease duration, baseline C-reactive protein (CRP) levels/magnetic resonance imaging (MRI) status, and timepoints, to ensure comparability between studies. Results: At 12-16 weeks, treatment with CZP was significantly more likely to achieve ASAS20/

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Response to: Correspondence on "ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update" by Ramiroet al

Cited by 106 publications

References 10 publications

Work participation in patients with axial spondyloarthritis: high prevalence of negative workplace experiences and long-term work impairment

Work participation in patients with axial spondyloarthritis: high prevalence of negative workplace experiences and long-term work impairment

Managing Psoriatic Arthritis Patients Presenting with Axial Symptoms

Comparative Efficacy of Biologic Disease-Modifying Anti-Rheumatic Drugs for Non-Radiographic Axial Spondyloarthritis: A Systematic Literature Review and Bucher Indirect Comparisons

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