Spondyloarthritis & psoriatic arthritis
Difficult to manage axial spondyloarthritis patients have high burden of pain-related comorbidities and adverse long-term outcome
Authors' conclusion
11.5% of axSpA patients developed D2M disease and showed adverse long-term outcome compared to non-D2M. While D2M patients had at baseline higher disease's burden, comorbidities mostly related to chronic pain syndromes predicted D2M development, supporting their significance for D2M axSpA evolution.
Study context
- Population
- Axial spondyloarthritis (axSpA) patients starting targeted agents (01/01/2007 until 28/02/2024), single centre2,312 patient-years follow-up
- Participants
- 434 patients
- Exposure
- Difficult to manage (D2M) axSpA vs non-D2M axSpA
- D2Mn = 50
- Outcome
- Prevalence, predictors and long-term outcomes of D2M axSpA
Methodological detailssingle-centre, multivariate logistic regression, K-means cluster analysis
- Single-centre
- Multivariate logistic regression
- K-means cluster analysis
Main finding
As reported in the abstract
Prevalence of D2M axSpA
D2M
11.5%
50
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Baseline disease activityHigher in D2M | P = 0.01 |
| Improvement in disease activity at 6 monthsD2M failed to improve | P < 0.0001 |
| Prevalence of dyslipidemia, OA and FMMore prevalent in D2M | P < 0.0001 |
Independent predictors of D2M development (multivariate logistic regression) · baseline
- Fibromyalgia, OR
- 3.55
- Osteoporosis, OR
- 5.67
- Dyslipidemia, OR
- 2.70
Comorbidity clusters contributing to D2M
- "Chronic pain syndromes" cluster, OR (p = 0.010)
- 2.52
- "Metabolic" cluster, OR (p = 0.013)
- 3.30
Long-term functional impairment
- Higher functional impairment in D2M vs non-D2M
Safety
| Outcome | P value |
|---|---|
| Serious adverse events and hospitalizations · 2312 patient-years follow-upMore in D2M | P = 0.016 |
Original publication
Difficult to manage axial spondyloarthritis patients have high burden of pain-related comorbidities and adverse long-term outcome. Arthritis Res Ther. Published 24 January 2026. doi:10.
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