Spondyloarthritis & psoriatic arthritis
Frequency of difficult-to-manage and treatment-refractory axial SpA: insights from the German RABBIT-SpA register using recent ASAS definitions
Authors' conclusion
Applying the ASAS definitions in a large real-world cohort identified clinically relevant subgroups with D2M and TR.
Study context
- Population
- b/tsDMARD-naïve axial SpA (axSpA) patients initiating a b/tsDMARD with ≥12 months of follow-up, German RABBIT-SpA registryof 1850 axSpA patients
- Participants
- 881 patients
- Exposure
- Difficult-to-manage (D2M) vs not-D2M axSpA; Treatment-refractory (TR) vs D2M/nTR
- Outcome
- Frequency of axSpA fulfilling the ASAS definitions for D2M and TR axSpA
Methodological detailsmulticentre, longitudinal, registry-based
- Multicentre
- Longitudinal
- Registry-based
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Baseline characteristics, D2M vs not-D2M (nD2M)
- D2M more frequently female, more often HLA-B27-negative, more commonly arthritis and enthesitis
- D2M fewer objective inflammatory markers such as elevated CRP or MRI lesions
- Opioid use higher in D2M
Baseline characteristics, TR vs D2M/nTR · initiation of first-line b/tsDMARD
- TR lower proportion of female and of obesity
- TR more frequently signs of inflammation, incl. sacroiliac/spinal MRI lesions and elevated CRP; peripheral arthritis less frequent
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Frequency of difficult-to-manage and treatment-refractory axial SpA: insights from the German RABBIT-SpA register using recent ASAS definitions. Rheumatology (Oxford). Published 3 December 2025. doi:10.
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