Evidence map›Paper›PMID 39804521›Full record

ArticleRheumatology and therapy2025

Association Between Diagnostic Delay and Economic and Clinical Burden in Axial Spondyloarthritis: A Multicentre Retrospective Observational Study.

Laura Berbel-Arcobé, María Aparicio, Joan Calvet, Marta Arévalo, Annika Nack, Xavier Juanola, Elide Toniolo, Stefano Maratia, Luis Lizán, Jordi Gratacós

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Article in Rheumatology and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Year in Review: Axial Spondyloarthritis.Mediterranean journal of rheumatology · 2026
    Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Laura Berbel-ArcobéRheumatology Department, Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain.
María AparicioRheumatology Department, Germans Trias i Pujol University Hospital, Barcelona, Spain.
Joan CalvetRheumatology Department, Parc Taulí University Hospital. Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Parc Taulí, 1, Sabadell, 08208, Barcelona, Spain.
Marta ArévaloRheumatology Department, Parc Taulí University Hospital. Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Parc Taulí, 1, Sabadell, 08208, Barcelona, Spain.
Annika NackRheumatology Department, Germans Trias i Pujol University Hospital, Barcelona, Spain.
Xavier JuanolaRheumatology Department, Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain.
Elide TonioloUCB Pharma, Madrid, Spain.
Stefano MaratiaUCB Pharma, Madrid, Spain.
Luis LizánOutcomes'10, Castellón, Spain.
Jordi GratacósRheumatology Department, Parc Taulí University Hospital. Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Parc Taulí, 1, Sabadell, 08208, Barcelona, Spain. jgratacosmas@gmail.com.ORCID http://orcid.org/0000-0003-4007-4103

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAxial spondyloarthritis (axSpA) is a chronic inflammatory condition associated with considerable pain and impaired health-related quality of life (HRQoL) for affected patients. Despite the documented increase in healthcare resource utilization (HRU) related to axSpA, few studies have explored the impact of diagnostic delays on these outcomes. This study sought to determine the association between diagnostic delay of axial spondyloarthritis (axSpA) and costs in the 3 years after diagnosis.

methodsThis is a retrospective, observational study based on routine follow-up data from adult patients with confirmed axSpA diagnosis in three tertiary Spanish hospitals. Sociodemographic and clinical variables were collected at diagnosis. Direct and indirect healthcare costs were estimated from healthcare resource use (HRU) and productivity losses. The correlation between diagnostic delay and total healthcare costs was analyzed.

resultsEighty-two patients (62.2% men; mean age: 39.3 years at diagnosis) were included, mostly with radiographic axSpA (r-axSpA) (67.1%). The mean (standard deviation, SD) diagnostic delay was 10.1 (9.3) years, with a median (interquartile range, IQR) of 5.4 (2.3, 17.2) years. The mean total healthcare cost per patient accumulated over 3 years was €25,812.6 (direct: €16,384.7; indirect: €9427.9). Patients with longer diagnostic delay (> 5.4 years) had 57% higher total healthcare cost (€31,717.7 vs. €20,188.7, p = 0.029) and higher disease activity at diagnosis (BASDAI score 4.7 vs. 3.4, p = 0.007) and after 3 years (3.9 vs. 2.9, p = 0.042) compared to those with shorter delay (≤ 5.4 years).

conclusionsThe diagnostic delay in axSpA remains high and is associated with an increase in healthcare costs post-diagnosis. Actions to reduce diagnostic delay should be prioritized by healthcare systems to potentially improve outcomes and reduce long-term costs.

Indexed as

Axial spondyloarthritisCostsDiagnostic delayDisease activityHealthcare resource utilization

Identifiers

PMID39804521
PMCPMC11920463

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.