ArticleRheumatology (Oxford, England)2025
Factors associated with treatment intensification in patients with axial spondyloarthritis and high disease activity in clinical practice.
Article in Rheumatology (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Patients' Perspectives Regarding Ankylosing Spondylitis Treatment Administration Features: Evidence from Qualitative Interviews and a Multinational Quantitative Preference Survey.Rheumatology and therapy · 2026Article
- Which ASDAS cut-off corresponds best to treatment intensification in patients with axial spondyloarthritis in daily practice? A prospective study from a clinical registry.Rheumatology international · 2025Article
- Barriers and facilitators to treat-to-target in axial spondyloarthritis in clinical practice: a mixed methods study.Rheumatology international · 2025Article
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6 authors.
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Abstract
objectiveTo investigate which factors are associated with treatment intensification (TI) in axial SpA (axSpA) patients with high disease activity (HDA).
methodsPatients with axSpA and HDA [Ankylosing Spondylitis Disease Activity Score (ASDAS) ≥2.1] from the Dutch SpA-Net registry were included. TI was defined as: (i) higher dose or shorter interval of the same drug, (ii) switch from current drug to another due to inefficacy or (iii) addition of a new drug. Only anti-inflammatory drugs were considered. Primary determinants considered were ASDAS, Assessment of SpondyloArthritis international Society Health Index (ASAS HI) and physician global assessment (PhGA). Acceptable symptom state according to patient (PASS-patient) or physician (PASS-physician) were included in sensitivity analyses. Patient-centred and physician-centred logistic regression models were used to investigate the association between potential determinants and TI.
resultsIn total, 121 patients with HDA were included. TI was conducted in a minority (41/121, 33.9%), and mainly involved a switch or addition of a drug. In multivariable regression analyses, a higher ASDAS was associated with TI in the patient-centred model [odds ratio (OR)ASDAS = 1.94 (95% CI 1.00-3.74)]. However, in the physician-centred model, this association attenuated, and PhGA or PASS-physician were the primary factors associated with TI [ORPhGA = 1.71 (1.24-2.34); ORPASS-physician = 94.95]. Interestingly, patient-centred factors (ASAS HI/PASS-patient/education level) did not contribute to TI.
conclusionIn practice, treatment is intensified in a minority of axSpA patients with HDA. Physician-centred factors are associated with the decision to change treatment, independently of disease activity or patient perspective. Further research is needed to better understand these decisions.
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