EULAR reported that three new studies may help physicians better diagnose and treat patients with axial spondyloarthritis. The new findings were presented by Marques et al, Marques et al, and Poddubnyy et al at the EULAR 2023 Congress and simultaneously published in the Annals of the Rheumatic Diseases.
In the first study, researchers examined the 2-year outcomes of the SPACE—the longitudinal SPondyloArthritis Caught Early—cohort, which included patients with recent-onset chronic back pain who were younger than 45 years of age at enrollment. The researchers found that among the 555 patients who participated in the trial, 175 of them received diagnoses of axial spondyloarthritis at baseline, and a total of 165 of them had confirmed definite diagnoses after 2 years. They also noted that characteristics of the disease, such as sacroiliitis, were more prevalent among those who received a definite diagnosis rather than those who had uncertain diagnoses. However, uncertainty and delayed treatment remained for 15% of patients who had recent-onset chronic back pain, highlighting a need for these patients to undergo multiple diagnostic assessments.
In the second study, researchers identified 32 instances in which patients’ diagnoses changed after multiple assessments. At baseline, 16 of these patients had been told they did not have axial spondyloarthritis—11 of these diagnoses being uncertain and 5 of them being definite. Factors such as imaging results and responses to medications contributed to changing diagnoses to definite axial spondyloarthitis during subsequent assessments.
In the third study—as part of the International Map of Axial Spondyloarthritis initiative—investigators analyzed the regional differences in the disease’s clinical phenotypes across 27 countries and 5 regions. The investigators discovered that patients in Latin America were older at the time of disease onset; patients in South Africa experienced the longest diagnostic delays; European patients had the highest recorded family history of the disease; and patients in Asia presented with the lowest frequencies of human leukocyte antigen B27 positivity. The investigators concluded that additional studies may be needed to more fully understand the regional differences between patients with axial spondyloarthritis, diagnose patients earlier, and reduce treatment delays.