Journal
RHEUMATOLOGY
Volume 58, Issue 11, Pages 2025-2030Publisher
OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/kez171
Keywords
ankylosing spondylitis; non-radiographic axial spondyloarthritis; comorbidity; biologic DMARDs; United States
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Funding
- Royal College of Physicians
- Royal Society of Medicine
- Pharmacoepidemiology Programme at the Harvard T.H. Chan School of Public Health (Pfizer)
- Pharmacoepidemiology Programme at the Harvard T.H. Chan School of Public Health (Takeda)
- Pharmacoepidemiology Programme at the Harvard T.H. Chan School of Public Health (Bayer)
- Pharmacoepidemiology Programme at the Harvard T.H. Chan School of Public Health (ASISA)
- Honjo International Scholarship Foundation
- [NIH-P30-AR072577]
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Objectives. 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. Methods. 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. Results. 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. Conclusion. 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.
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