The following is a summary of “Axial spondyloarthritis treatment recommendations and disease activity monitoring in clinical practice – results of an online survey,” published in the January 2024 issue of Rheumatology by Sinnappan et al.
Researchers conducted a retrospective study through an online survey to identify potential barriers to consistently implementing treatment recommendations in axial spondyloarthritis and ankylosing spondylitis (axSpA/AS).
They initiated the study by sending email invitations to US rheumatology care providers in January 2023, with the questionnaire comprising 20 questions and an estimated completion time of 5-7 minutes.
The result showed that of 441 invitees, 104 (23%) participated, including 80/104 (77%) board-certified rheumatologists and 20/104 (19%) fellows. Survey respondents identified UptoDate (85%), treatment guidelines (74%), and colleagues (54%) as relevant knowledge sources for managing axSpA/AS. Approximately 64% and 53% of participants considered themselves to be at least moderately familiar with the ACR/SAA/SPARTAN and ASAS/EULAR treatment recommendations for axSpA/AS, respectively. While 69% of participants agreed or strongly agreed that disease activity scores are helpful for treatment decisions in axSpA/AS, only 37% measure patient-reported outcomes (PROs) frequently (≥50% of clinic visits), while 82% do so for CRP/ESR. PROs are recorded during clinic encounters (65%), and CRP/ESR are obtained after the visit (86%). Regarding usefulness for measuring disease activity in axSpA/AS, 57% and 47% of participants considered BASDAI and ASDAS to be at least moderately useful, while 41% and 37% thought the same about ASAS20 and CDAI.
Investigators concluded that while axSpA guidelines advocate for active disease monitoring, rheumatologists face barriers like unfamiliarity and poor PRO infrastructure, hindering its implementation.
Source: jrheum.org/content/early/2024/01/09/jrheum.2023-0894