Article Text
Abstract
Background Monitoring is an important part of the disease management in patients with axial spondyloarthritis (axSpA) [1].
Objectives is to evaluate the differences in adherence to therapy and in treatment outcomes in patients with the different ways of SpA monitoring.
Methods A total of 168 TNFα-blockers naïve patients with axial SpA fulfilling the ASAS criteria with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥4 were involved in the current study and followed-up for one year. Ninety six patients were managed in by a local rheumatologist, who determined the frequency of monitoring and treatment required (group 1); 26 patients were managed actively – they visited rheumatologist every 12 weeks (group 2); 46 patients were involved in the group of the remote telephone monitoring – a monitor called them every 4 weeks and collected data about treatment and disease activity (group 3). Data on treatment and disease activity (BASDAI, the Ankylosing Spondylitis Disease Activity Score – ASDAS, and the patient acceptable symptom state – PASS) were collected at baseline and after 1 year of follow-up. Patients were asked if they need a rheumatologist's consultation.
Results In group 1 BASDAI at baseline was 5.32±3.2, after one year – 5.17±2.16, ASDAS – 3.45±2.1 and 3.1±1.1, respectively (p>0.05). In group 2 BASDAI at baseline was 5.21±3.0, after 1 year – 4.77±2.2, p<0.05, ASDAS – 3.42±2.9 and 2.79±2.6, respectively, p<0.05. In group 3 (remote monitoring) BASDAI at baseline was 5.36±3.5, after one year – 3.17±2.12, p<0.05, ASDAS – 3.44±3.1 and 2.6±1.8, respectively, p<0.05. Positive PASS at one year was achieved in the group 3 in 15 (57.69%, n=26), in group 2 - in 4 (20%, n=20), and in group 1 – in 0 (0%) of the cases. During one year non-steroid anti-inflammatory drugs intake recommended at baseline was changed arbitrarily (canceling the treatment/reducing the dose of medication) by 5 (19.23%, n=26), 15 (75%, n=20), 93 (96.87%, n=96) patients in groups 3, 2 and 1, respectively. After one year of follow up 3 patients of group 3 (11.5%, n=26), 19 (95%, n=20) of group 2 and 96 (100%) patients of group 1 considered that they need to visit a rheumatologist.
Conclusions Regular monitoring is associated with a better therapy outcome in axSpA. Remote telephone monitoring of SpA every 4 weeks seems to beneficial regarding better adherence to therapy and better treatment outcomes than active monitoring of the disease every 12 weeks or irregular monitoring.
References
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Braun J. Ann Rheum Dis. 2011; 70: 896–904.
Disclosure of Interest : None declared
DOI 10.1136/annrheumdis-2014-eular.3960