OBJECTIVES To better understand the quality of life (QoL), clinical characteristics, symptoms, and treatment patterns of non-radiographic axial spondyloarthritis (nr-axSpA) patients and how they compare to ankylosing spondylitis (AS) patients.

METHODS Data from a cross-sectional survey conducted with physicians and patients in Australia, Canada, France, Germany, Italy, Japan, Spain, United Kingdom and the United States were analyzed. Demographics, disease status, remission status, symptoms, and medication use were reported by the physician, while work disability and QoL measures were reported by the patient. QoL and treatment patterns of nr-axSpA and AS patients were compared using parametric tests and non-parametric tests.

RESULTS Data from 432 physicians, 2,300 AS patients, and 2,099 nr-axSpA patients were included in this analysis. A higher proportion of nr-axSpA patients were female (p<0.0001) and had a younger mean age (p=0.0001) compared to AS patients. Nr-axSpA patients’ current disease status were less likely to be stable (p=0.0005), they were also less likely to be in remission (p=0.0008), and were less likely to be prescribed biologic therapy (p<0.0001) than AS patients. On average, AS patients experienced more symptoms (p=0.0001), however, more nr-axSpA patients were reported to experience inflammatory back pain (p=0.0187), back pain for more than 3 months (p=0.0010), morning stiffness for more than 30 minutes (p=0.0361), alternating buttock pain (p=0.0166) and dactylitis (p=0.0009). Patient reported outcomes such as the ASAS HI (p=0.4625), BASDAI (p=0.9547) and WPAI (p=0.0919) were similar between nr-axSpA and AS patients.

CONCLUSIONS Patients with nr-axSpA and AS share many of the same clinical features. However, in spite of these similarities, patients with nr-axSpA are less likely to be treated with a biologic, show lower rates of stability and are less likely to be in remission. The burden of the disease, as assessed by QoL measurements, is similar for AS and nr-axSpA patients and therefore, the treatment approach should be similar.