Difficult-to- manage and treatment refractory axial Spondyloarthritis: Systematic review and meta-analysis of prevalence and determinants.

What was studied

This review pooled studies of axSpA that is hard to manage. It also looked at axSpA that does not respond to treatment. Patients in these studies had failed at least 2 drugs. The drugs worked in different ways. Their disease was still active. The review had 11 studies with 5648 patients.

What they found

The abstract gives a pooled rate of hard-to-manage disease. Prospective multicenter studies gave a steady estimate. Fibromyalgia was the factor most strongly linked to this status. HLA-B27 positivity and smoking were also linked. Female sex was not clearly linked. Higher baseline BASDAI scores were seen in these patients. Links with age and disease duration were not consistent.

What it means for patients

The authors say fibromyalgia, smoking and HLA-B27 positivity stood out as linked factors. They say true treatment-refractory disease is a smaller group. They say the findings support telling apart inflammatory and non-inflammatory causes of ongoing disease burden.

Why it is not certain yet

Cross-sectional designs cannot show cause. Results for sex varied a lot between studies. Links with age and disease duration were inconsistent. Other features showed non-significant trends.

Source

Difficult-to- manage and treatment refractory axial Spondyloarthritis: Systematic review and meta-analysis of prevalence and determinants.

We restate facts from the source record in our own words. The original wording belongs to its publisher.