Comparison of comorbidities and treatment between ankylosing spondylitis and non-radiographic axial spondyloarthritis in the United States

Zhao, Sizheng Steven ORCID: 0000-0002-3558-7353, Ermann, Joerg, Xu, Chang, Lyu, Houchen, Tedeschi, Sara K, Liao, Katherine P, Yoshida, Kazuki, Moots, Robert J ORCID: 0000-0001-7019-6211, Goodson, Nicola J ORCID: 0000-0003-0714-3568 and Solomon, Daniel H (2019) Comparison of comorbidities and treatment between ankylosing spondylitis and non-radiographic axial spondyloarthritis in the United States. RHEUMATOLOGY, 58 (11). pp. 2025-2030.

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Abstract

<h4>Objectives</h4>This study aimed to compare comorbidities and biologic DMARD (bDMARD) use between AS and non-radiographic axial SpA (nr-axSpA) patients, using a large cohort of patients from routine clinical practice in the United States.<h4>Methods</h4>We performed a cross-sectional study using electronic medical records from two academic hospitals in the United States. Data were extracted using automated searches (⩾3 ICD codes combined with text searches) and supplemented with manual chart review. Patients were categorized into AS or nr-axSpA according to classification criteria. Disease features, comorbidities (from a list of 39 chronic conditions) and history of bDMARD prescription were compared using descriptive statistics.<h4>Results</h4>Among 965 patients identified, 775 (80%) were classified as having axSpA. The cohort was predominantly male (74%) with a mean age of 52.5 years (s.d. 16.8). AS patients were significantly older (54 vs 46 years), more frequently male (77% vs 64%) and had higher serum inflammatory markers than those with nr-axSpA (median CRP 3.4 vs 2.2 mg/dl). Half of all patients had at least one comorbidity. The mean number of comorbidities was 1.5 (s.d. 2.2) and similar between AS and nr-axSpA groups. A history of bDMARD-use was seen in 55% of patients with no difference between groups. The most commonly prescribed bDMARDs were adalimumab (31%) and etanercept (29%). Ever-prescriptions of individual bDMARDs were similar between AS and nr-axSpA.<h4>Conclusion</h4>Despite age differences, nr-axSpA patients had similar comorbidity burdens as those with AS. Both groups received comparable bDMARD treatment in this United States clinic-based cohort.

Item Type:	Article
Uncontrolled Keywords:	ankylosing spondylitis, non-radiographic axial spondyloarthritis, comorbidity, biologic DMARDs, United States
Depositing User:	Symplectic Admin
Date Deposited:	21 Aug 2019 08:12
Last Modified:	19 Jan 2023 00:28
DOI:	10.1093/rheumatology/kez171
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3052223