Background:

Despite the availability of several potent anti-inflammatory treatment options, only about 40 to 50% of patients with axial spondyloarthritis (axSpA) achieve the ASAS40 response and even lower proportion of patients (approximately 10-20%) achieve remission or inactive disease activity state within 16 to 24 weeks of treatment according to the data from randomized controlled trials with b- and tsDMARDs. There are several potential reasons for the non-response or partial response in axSpA, which can be related to the disease itself, but could also be related to factors other than biological non-response (e.g., chronic pain syndrome, concomitant degenerative disease, etc.).

Aim:

Within the ASAS D2T SpA initiative we aim to develop a consensus definition of a difficult-to-treat axSpA that is primarily related to the biological nonresponse, i.e., active disease despite sufficient anti-inflammatory treatment. The definition is intended for clinical research focusing on characterization of those patients, identification of the mechanisms beyond the refractory disease and conducting interventional trials.

Methodology:

The project will include the following steps:

• Literature review to identify potential elements or existing definitions of DT2 SpA.
• Online survey among ASAS members related to the potential elements of the definition of a D2T SpA.
• Development of the first draft of the definition based on the survey results by the steering committee.
• Meeting of the task force with discussion of the proposed definition, amendments, development of the final version and voting.
• Presentation of the final definition at the ASAS annual meeting and endorsement.

Timelines of the project: 2022 – ongoing

 

Project Team

PI: Denis Poddubnyy, Désirée van der Heijde

Steering committee:

Xenofon Baraliakos

Victoria Navarro Compan

Désirée van der Heijde

Denis Poddubnyy

 

Fellow:

Murat Torgutalp