Spondyloarthritis & psoriatic arthritis
Determinants of Difficult‐to‐Manage and Treatment‐Refractory Axial Spondyloarthritis: A Cross‐Sectional Analysis Within a Longitudinal Cohort
Authors' conclusion
Approximately 1 in 10 patients with axSpA in this cohort fulfilled the ASAS D2M definition, with a smaller proportion classified as having TR axSpA. D2M status was associated with higher spinal pain and fibromyalgia, whereas patients with TR axSpA had active disease with fewer noninflammatory pain contributors.
Study context
- Population
- Patients with axial spondyloarthritis (axSpA) in the Schroeder Arthritis Institute Spondylitis Program cohort
- Participants
- 536 patients
- Exposure
- Difficult-to-manage (D2M) vs non-D2M axSpA; Treatment-refractory (TR) axSpA
- D2Mn = 49
- TRn = 12
- Outcome
- Prevalence of D2M and TR axSpA (ASAS definitions)
Methodological detailscross-sectional analysis within a longitudinal cohort, multivariable logistic regression
- Cross-sectional analysis within a longitudinal cohort
- Multivariable logistic regression
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Factors independently associated with D2M (multivariable analysis)
| OR (95% CI) | ||
|---|---|---|
| Higher spinal pain scores | 1.48 (1.29–1.70) | |
| Fibromyalgia | 3.09 (1.33–7.15) | |
| 0.10.31310Odds ratio (log scale) |
Characteristics of D2M vs non-D2M axSpA
- D2M: higher disease activity, worse function and spinal mobility, higher prevalence of comorbidities, degenerative spine disease and FM
Characteristics of TR axSpA
- TR: greater disease burden, more often male, HLA-B27-positive and r-axSpA, less affected by noninflammatory pain contributors
Original publication
Determinants of Difficult‐to‐Manage and Treatment‐Refractory Axial Spondyloarthritis: A Cross‐Sectional Analysis Within a Longitudinal Cohort. Arthritis Rheumatol. Published 27 April 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →