Objectives To rate the effectiveness of therapeutic strategies to achieve the goal (T2T) on the example of Kazan cohort of patients with spondyloarthritis (SpA) compared with routine practice
Methods The main group of active observation by rheumatologist and regular correction of therapy according to the T2T criteria for spondyloarthritis included 42 patients: 27 (64.3%) with ankylosing spondylitis (AS) - New York criteria, 15 (35.7%) with axial SpA and positive MRI osteitis. High and very high activity (ASDAS) was at 54.8%, moderate - at 45.2% of patients. The comparison group - 40 patients (65% - AS, 35% - axial SpA) observed in the routine practice with a rheumatologist consultation as needed (just about once in 6 months). Patients were comparable for demographic and clinical characteristics, disease activity, duration of symptoms was not more than 10 years, the average 5,1±2,7. All patients received nonsteroidal anti-inflammatory drugs (NSAIDs), if necessary on a long constant reception. At baseline and after 3, 6 and 12 months BASDAI, ASDAS, BASFI, remission criteria (ASAS) were determined, adherence to treatment was evaluated.
Results During the observation period in two groups a decrease (p<0.05) of mean values BASDAI, BASFI, ASDASCRP was noticed. For the year of observation in the main group 95.2% of patients showed improvement on ASAS40 criteria, partial remission ASAS criteria was reached at 3 months - 47.6% of patients, at 6 months - 73.8%, at 12 months - 80, 9%, periods of exacerbation were observed in 19.1% of patients.
In the comparison group - 55% of patients showed improvement on ASAS40 criteria, after 3 months partial remission ASAS criteria was reached in 17.5% of patients, at 6 months - 35%, 12 months - 47.5% patients, periods of exacerbation were observed in 57.5% of patients.
The number of patients, regulary performed physical exercises, in the study group was 73.8%, in the control group - 35%. In the study group 76.1% of patients received NSAIDs continuously, in the control group - 37.5% of patients - only on request
Conclusions The treatment strategy T2T SpA is an effective tool for the management of patients with this pathology, improves adherence to therapy, helps to control disease activity, improves functional status.
Disclosure of Interest None declared