Residual disease in axSpA more prevalent, severe in female patients

Patients with axial spondyloarthritis (axSpA) who are in a low disease activity (LDA) state or in remission tend to experience residual disease, which occurs more frequently among female patients, reveals a recent study.

One timepoint per patients was used from SpA-Net, a web-based monitoring registry for SpA, for this cross-sectional observational study, which included patients with an Ankylosing Spondylitis Disease Activity Score (ASDAS) <2.1 (LDA).

Indicators of residual disease were as follows: fatigue (primary outcome), pain, physical functioning, health-related quality of life (HRQOL), and peripheral symptoms. Sex was the main explanatory factor for residual disease, and other factors included demographics and disease-related factors. The authors explored associations between these factors and residual disease using logistic and linear regression.

A total of 267 patients (mean age 50.6 years, 37.5 percent female) in an LDA state were included. Residual disease often occurred in this population (114 patients [42.7 percent] had fatigue scores >4/10; 34 [17.8 percent] had pain scores >4/10), as well as in those currently in remission (ASDAS <1.3). In addition, physical HRQOL decreased in 27 percent and was moderate or poor in 33 percent of patients.

In multivariable analyses, reported fatigue was more prevalent and more severe in female patients (fatigue severity [0‒10]: B, 0.78, 95 percent confidence interval [CI], 0.18‒1.38; fatigue >4/10: odds ratio, 3.29, 95 percent CI, 1.74‒6.20). Other indicators of residual disease, such as pain, peripheral symptoms, and physical HRQOL, were also more severe or more prevalent in women.

“Future studies should address how to manage or prevent residual disease in axSpA,” the authors said.