TY - JOUR T1 - One-Third of European Patients with Axial Spondyloarthritis Reach Pain Remission With Routine Care Tumor Necrosis Factor Inhibitor Treatment JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.220459 SP - jrheum.220459 AU - Lykke Midtbøll Ørnbjerg AU - Kathrine Rugbjerg AU - Stylianos Georgiadis AU - Simon Horskjær Rasmussen AU - Ulf Lindström AU - Karel Pavelka AU - Neslihan Yilmaz AU - Ennio Giulio Favalli AU - Michael J. Nissen AU - Brigitte Michelsen AU - Elsa Vieira-Sousa AU - Gareth T. Jones AU - Ruxandra Ionescu AU - Heikki Relas AU - Carlos Sanchez-Piedra AU - Matija Tomšič AU - Arni Jon Geirsson AU - Irene van der Horst-Bruinsma AU - Johan Askling AU - Anne Gitte Loft AU - Lucie Nekvindova AU - Haner Direskeneli AU - Florenzo Iannone AU - Adrian Ciurea AU - Karen Minde Fagerli AU - Maria José Santos AU - Gary J. Macfarlane AU - Catalin Codreanu AU - Kari Eklund AU - Manuel Pombo-Suarez AU - Ziga Rotar AU - Bjorn Gudbjornsson AU - Tamara Rusman AU - Mikkel Østergaard AU - Merete Lund Hetland Y1 - 2022/12/01 UR - http://www.jrheum.org/content/early/2023/01/10/jrheum.220459.abstract N2 - Objective To investigate the distribution of patient-reported outcomes (PROs) in patients with axial spondyloarthritis (axSpA) initiating a tumor necrosis factor inhibitor (TNFi), to assess the proportion reaching PRO "remission" across registries and treatment series, and to compare patients registered to fulfill the modified New York (mNY) criteria for ankylosing spondylitis (AS) vs patients with nonradiographic axSpA (nr-axSpA). Methods Fifteen European registries contributed PRO scores for pain, fatigue, patient global assessment (PtGA), Bath Ankylosing Spondylitis (AS) Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), and Health Assessment Questionnaire (HAQ) from 19,498 patients with axSpA. Changes in PROs and PRO remission rates (definitions: ≤ 20 mm for pain, fatigue, PtGA, BASDAI, and BASFI; ≤ 0.5 for HAQ) were calculated at 6, 12, and 24 months of treatment. Results Heterogeneity in baseline characteristics and outcomes between registries were observed. In pooled data, 6 months after the start of a first TNFi, pain score was reduced by approximately 60% (median at baseline/ 6/12/24 months: 65/25/20/20 mm) in patients on treatment. Similar patterns were observed for fatigue (68/32/30/25 mm), PtGA (66/29/21/20 mm), BASDAI (58/26/21/19 mm), BASFI (46/20/16/16 mm), and HAQ (0.8/0.4/0.2/0.2). Patients with AS (n = 3281) had a slightly better response than patients with nr-axSpA (n = 993). The Lund Efficacy Index (LUNDEX)-adjusted remission rates at 6 months for pain/fatigue/PtGA/BASDAI/BASFI/HAQ were 39%/30%/38%/34%/35%/48% for the AS cohort and 30%/21%/26%/24%/33%/47% for the nr-axSpA cohort. Better PRO responses were seen with a first TNFi compared to a second and third TNFi. Conclusion Patients with axSpA starting a TNFi achieved high PRO remission rates, most pronounced in those fulfilling the mNY criteria and for the first TNFi. ER -