加拿大轴性脊柱关节炎患者的残余疾病活动度和疾病负担：多登记处分析（UNISON-Axial SpA）结果

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

作者信息

Choquette Denis, Gladman Dafna D, Inman Robert D, Rahman Proton, Laliberté Marie-Claude, Fournier Pierre-André, Girard Tanya, Wichuk Stephanie, Coupal Louis, Chandran Vinod, Rohekar Sherry, Boyd Tristan, Zummer Michel, Richard Nicolas, Thorne Carter, Mosher Dianne, Ziouzina Olga, Tsoukas Alexander, Starr Michael, Chan Jonathan, Aydin Sibel Zehra, Maksymowych Walter P

机构信息

D. Choquette, MD, Institut de Rhumatologie de Montréal, CHUM, University of Montréal, Montreal, Quebec.

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.

出版信息

J Rheumatol. 2025 Aug 1. doi: 10.3899/jrheum.2024-1303.

DOI:10.3899/jrheum.2024-1303

PMID:40592555

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.

摘要

目的

在量化加拿大轴向性脊柱关节炎（axSpA）患者的残余疾病活动度方面存在关键的知识空白。本研究的目的是评估和描述加拿大axSpA患者的残余疾病活动度和疾病负担。

方法

这是一项对从Rhumadata（魁北克）、加拿大脊柱关节炎研究联盟（SPARCC；东部/大西洋地区、西部地区以及安大略省）和强直性脊柱炎随访研究队列（FORCAST；艾伯塔省）登记处提取的数据进行的观察性回顾性分析。主要终点是在12个月时未达到持续低疾病活动度（LDA）的患者比例。LDA定义为巴斯强直性脊柱炎疾病活动指数（BASDAI）评分<3，持续LDA定义为在最近一次治疗改变后6个月和12个月均达到LDA。分析包括按治疗类别（非甾体抗炎药、肿瘤坏死因子抑制剂或白细胞介素17抑制剂）的结果。

结果

共纳入980例患者（Rhumadata，N = 488；SPARCC，N = 239；FORCAST，N = 253）。来自Rhumadata的axSpA患者中近一半（49.5%）和FORCAST的患者（55.3%）以及SPARCC的患者中65.8%在治疗开始后6个月未达到LDA（BASDAI<3）。在12个月时，Rhumadata中未达到持续LDA的比例升至62%，FORCAST中为65.1%，SPARCC中为81%。几乎一半的患者疼痛持续存在。