Maintained activity in ankylosing spondylitis patients treated with TNFi and/or NSAID for at least 12 weeks: a cross-sectional study in Brazil
Abstract Background The aim of this study was to evaluate disease activity among patients with axial spondyloarthritis (AS) treated with tumor necrosis factor inhibitors (TNFi) and/or nonsteroidal anti-inflammatory drugs (NSAIDs) for at least 12 weeks in private outpatient settings in Brazil. Method...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | Advances in Rheumatology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42358-022-00270-3 |
| _version_ | 1811257273244188672 |
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| author | Ricardo Acayaba de Toledo Felipe Merchan Ferraz Grizzo Vander Fernandes Renato Calheiros Ricardo T. Russo Gustavo Rosal Luiz Roberto Delboni Marchese Roberto Tunala Renato Watanabe Marina Gabriela Birck Guilherme Silva Julian Francisco Jose Forestiero |
| author_facet | Ricardo Acayaba de Toledo Felipe Merchan Ferraz Grizzo Vander Fernandes Renato Calheiros Ricardo T. Russo Gustavo Rosal Luiz Roberto Delboni Marchese Roberto Tunala Renato Watanabe Marina Gabriela Birck Guilherme Silva Julian Francisco Jose Forestiero |
| author_sort | Ricardo Acayaba de Toledo |
| collection | DOAJ |
| description | Abstract Background The aim of this study was to evaluate disease activity among patients with axial spondyloarthritis (AS) treated with tumor necrosis factor inhibitors (TNFi) and/or nonsteroidal anti-inflammatory drugs (NSAIDs) for at least 12 weeks in private outpatient settings in Brazil. Methods This was a cross-sectional, real-world study conducted in 17 Brazilian private health care institutes. Patients were selected if diagnosed with AS or axial radiographic spondyloarthritis (AxSpA) and treated with NSAIDs or TNFi for at least 12 weeks within the last 26 weeks prior to enrollment. The data were collected from interviewed-based and self-administered questionnaires from patients and physicians. Disease activity was defined as active (≥ 4), low /suboptimal (≥ 2 and < 4) and inactive (< 4) by Bath AS Disease Activity Index (BASDAI) and/or very high (≥ 3.5), high (≥ 2.1 to < 3.5), low (≥ 1.3 to < 2.1), and inactive (< 1.3) by AS Disease Activity Score (ASDAS-CRP). Both patients and physicians’ perceptions of disease control were assessed using a numeric rating scale (NRS; 0—inactive to 10—very active disease). Results The cohort included 378 patients with a mean age of 46 years, and the median time since diagnosis until enrollment was 5.4 years (interquartile range 2.7–10.5). Most patients were treated with TNFi alone (74%), followed by TNFi in combination with NSAID (15%), and NSAID alone (11%). About half AS patients showed active disease and 24% of patients showed low activity/suboptimal disease control despite having been treated for at least 12 weeks. Although TNFi showed better disease control than NSAID, inactive disease was experienced by few patients. The NRS (mean [standard deviation]) score for disease perception was 4.24 (3.3) and 2.85 (2.6) for patients and physicians, respectively. Conclusion This real-world study showed that most AS patients on TNFi and/or NSAID had not achieved an adequate disease control, as almost 75% of them exhibited active disease or low activity/suboptimal disease control. There remains a need for improved disease management among patients with AS. |
| first_indexed | 2024-04-12T17:53:54Z |
| format | Article |
| id | doaj.art-7feb9fd2ab504bbfb955509a3b65c8c0 |
| institution | Directory Open Access Journal |
| issn | 2523-3106 |
| language | English |
| last_indexed | 2024-04-12T17:53:54Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Advances in Rheumatology |
| spelling | doaj.art-7feb9fd2ab504bbfb955509a3b65c8c02022-12-22T03:22:25ZengBMCAdvances in Rheumatology2523-31062022-10-0162111010.1186/s42358-022-00270-3Maintained activity in ankylosing spondylitis patients treated with TNFi and/or NSAID for at least 12 weeks: a cross-sectional study in BrazilRicardo Acayaba de Toledo0Felipe Merchan Ferraz Grizzo1Vander Fernandes2Renato Calheiros3Ricardo T. Russo4Gustavo Rosal5Luiz Roberto Delboni Marchese6Roberto Tunala7Renato Watanabe8Marina Gabriela Birck9Guilherme Silva Julian10Francisco Jose Forestiero11Fundação Faculdade Regional de Medicina de São José do Rio PretoParaná Medical Research CenterCentro De Infusão de Biológicos - CIBNovartis Pharmaceuticals CorporationNovartis Biociências S.ANovartis Biociências S.ANovartis Biociências S.ANovartis Biociências S.AIQVIA BrasilIQVIA BrasilIQVIA BrasilNovartis Biociências S.AAbstract Background The aim of this study was to evaluate disease activity among patients with axial spondyloarthritis (AS) treated with tumor necrosis factor inhibitors (TNFi) and/or nonsteroidal anti-inflammatory drugs (NSAIDs) for at least 12 weeks in private outpatient settings in Brazil. Methods This was a cross-sectional, real-world study conducted in 17 Brazilian private health care institutes. Patients were selected if diagnosed with AS or axial radiographic spondyloarthritis (AxSpA) and treated with NSAIDs or TNFi for at least 12 weeks within the last 26 weeks prior to enrollment. The data were collected from interviewed-based and self-administered questionnaires from patients and physicians. Disease activity was defined as active (≥ 4), low /suboptimal (≥ 2 and < 4) and inactive (< 4) by Bath AS Disease Activity Index (BASDAI) and/or very high (≥ 3.5), high (≥ 2.1 to < 3.5), low (≥ 1.3 to < 2.1), and inactive (< 1.3) by AS Disease Activity Score (ASDAS-CRP). Both patients and physicians’ perceptions of disease control were assessed using a numeric rating scale (NRS; 0—inactive to 10—very active disease). Results The cohort included 378 patients with a mean age of 46 years, and the median time since diagnosis until enrollment was 5.4 years (interquartile range 2.7–10.5). Most patients were treated with TNFi alone (74%), followed by TNFi in combination with NSAID (15%), and NSAID alone (11%). About half AS patients showed active disease and 24% of patients showed low activity/suboptimal disease control despite having been treated for at least 12 weeks. Although TNFi showed better disease control than NSAID, inactive disease was experienced by few patients. The NRS (mean [standard deviation]) score for disease perception was 4.24 (3.3) and 2.85 (2.6) for patients and physicians, respectively. Conclusion This real-world study showed that most AS patients on TNFi and/or NSAID had not achieved an adequate disease control, as almost 75% of them exhibited active disease or low activity/suboptimal disease control. There remains a need for improved disease management among patients with AS.https://doi.org/10.1186/s42358-022-00270-3Ankylosing spondylitisAxial radiographic spondyloarthritisDisease activityNonsteroidal anti-inflammatory drugPatient-reported outcomeReal-world study |
| spellingShingle | Ricardo Acayaba de Toledo Felipe Merchan Ferraz Grizzo Vander Fernandes Renato Calheiros Ricardo T. Russo Gustavo Rosal Luiz Roberto Delboni Marchese Roberto Tunala Renato Watanabe Marina Gabriela Birck Guilherme Silva Julian Francisco Jose Forestiero Maintained activity in ankylosing spondylitis patients treated with TNFi and/or NSAID for at least 12 weeks: a cross-sectional study in Brazil Advances in Rheumatology Ankylosing spondylitis Axial radiographic spondyloarthritis Disease activity Nonsteroidal anti-inflammatory drug Patient-reported outcome Real-world study |
| title | Maintained activity in ankylosing spondylitis patients treated with TNFi and/or NSAID for at least 12 weeks: a cross-sectional study in Brazil |
| title_full | Maintained activity in ankylosing spondylitis patients treated with TNFi and/or NSAID for at least 12 weeks: a cross-sectional study in Brazil |
| title_fullStr | Maintained activity in ankylosing spondylitis patients treated with TNFi and/or NSAID for at least 12 weeks: a cross-sectional study in Brazil |
| title_full_unstemmed | Maintained activity in ankylosing spondylitis patients treated with TNFi and/or NSAID for at least 12 weeks: a cross-sectional study in Brazil |
| title_short | Maintained activity in ankylosing spondylitis patients treated with TNFi and/or NSAID for at least 12 weeks: a cross-sectional study in Brazil |
| title_sort | maintained activity in ankylosing spondylitis patients treated with tnfi and or nsaid for at least 12 weeks a cross sectional study in brazil |
| topic | Ankylosing spondylitis Axial radiographic spondyloarthritis Disease activity Nonsteroidal anti-inflammatory drug Patient-reported outcome Real-world study |
| url | https://doi.org/10.1186/s42358-022-00270-3 |
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