Spondyloarthritis & psoriatic arthritis
Does symptom duration impact on treatment response in axial spondyloarthritis? A meta-analysis of randomized controlled trials
Authors' conclusion
Based on a meta-analysis of 11 trials, no significant differences were found in the efficacy of bDMARDs compared with placebo in patients with axSpA with shorter vs longer symptom duration, across thresholds from 2 to 5 years.
Study context
- Population
- Adult axial spondyloarthritis (axSpA) patients in RCTs comparing b/tsDMARDs to placebo
- Participants
- 3,272 patients11 bDMARD RCTs
- Comparison
- bDMARD vs placebo, by shorter vs longer symptom duration
- Outcome
- ASAS40 response
- Follow-up
- Each trial's primary end point
Methodological detailsplacebo-controlled RCTs, random-effects meta-analysis, No studies involving tsDMARDs met the eligibility criteria
- Placebo-controlled RCTs
- Random-effects meta-analysis
- No studies involving tsDMARDs met the eligibility criteria
Pooled result
As reported in the abstract
ASAS40 response, bDMARD vs placebo, 2-year symptom duration threshold
Pooled relative risk (95% CI)
Early axSpAvs Established disease
2.04(1.48–2.84)
Established disease
2.28(1.65–3.15)
- Early axSpA vs Established disease · no statistical significance
- RRR 0.89 (95% CI 0.63–1.26)
Further pooled results
Other outcomes (disease activity, function, QoL) and other thresholds (3-5 years)
- No significant differences between efficacy in shorter and longer symptom duration
Original publication
Does symptom duration impact on treatment response in axial spondyloarthritis? A meta-analysis of randomized controlled trials. Rheumatology (Oxford). Published 11 July 2025. doi:10.
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