OBJECTIVES: Non-radiographic axial spondyloarthritis (nr-axSpA) is an inflammatory arthritic disease characterized by sacroiliac joint inflammation. Studies indicate that nr-axSpA is a long-term chronic condition and can impose a considerable burden on the patients’ physical function, impairment, and health-related quality of life. This analysis aimed to investigate whether elements of the burden associated with nr-axSpA are avoidable. METHODS: Data were from the 2014 nr-axSpA Disease Specific Programme, a cross-sectional, multi-national survey of patients and rheumatologists conducted in France, Germany, Italy, Spain and the UK. Rheumatologists completed forms containing patient demographics, clinical results and symptomology. Patients completed patient self-completions (PSCs) containing the Work Productivity and Activity Impairment questionnaire and EuroQoL-5D (EQ-5D-3L) with the visual analogue scale (EQ-VAS). Biologic treatment naïve patients considered eligible for biologics by the physician were compared to patients receiving biologics for ≥6 months. Observations were weighted to ensure findings were more representative of the patient population. The weight was applied to all percentages, means and standard deviations (SDs). Appropriate weighted univariate regressions were performed to test for significance. RESULTS: The analysis comprised of 310 patients (mean age 42.5±11.8 [SD], 74.8% male), with 123 biologic-naïve and 187 biologic-treated patients. Only 76 PSCs were completed in total. Compared to biologic-treated patients, biologic-naïve patients had greater overall work impairment (37.1% vs. 18.8%), presenteeism (27.6% vs. 15.8%) and activity impairment (31.4% vs. 22.5%). Additionally, more biologic-naïve patients were currently experiencing acute episodes (12.7% vs. 2.5%) and inflammatory back pain (69.5% vs. 38.5%) (all p<0.05). There were no observed differences between cohorts regarding mean EQ-5D utility score (0.81 vs. 0.82) or EQ-VAS (65.5 vs. 64.8). CONCLUSIONS: A potential unmet has been highlighted in nr-axSpA patient management, which could be due to restrictions upon physicians prescribing choices. Reducing the duration between diagnosis and biologic treatment prescription could potentially lessen the societal and clinical burden of nr-axSpA.