OBJECTIVES

To describe medication use and reasons for switching biologic therapy among patients with non-radiographic axial spondyloarthritis (nr-axSpA).

METHODS

Data from a cross-sectional survey conducted in Australia, Canada, France, Germany, Italy, Japan, Spain, United Kingdom and the United States were analyzed. Physicians completed record forms containing information on current medication use and reasons for switching biologics.

RESULTS

Data from 432 physicians (407 rheumatologists, 13 orthopedists, 12 internists) and 2,099 nr-axSpA patients were included in this analysis. The majority of nr-axSpA patients were male (54.6%), with a mean age of 42.7 years, and 60.0% of patients reported working full-time. Of the 2,009 nr-axSpA patients, 47.5% were receiving a biologic agent and no csDMARD, 23.6% NSAIDS/COX-2 (no biologic or csDMARD), 15.1% csDMARD (no biologic), 9.8% a biologic and a csDMARD, 2.1% were receiving no therapy, and 2.0% other therapy (no biologic, csDMARD or NSAID/COX-2). Of the 1,202 patients receiving a biologic, 79.5% were receiving their first, 12.9% their second and 7.6% their third or more biologic. Of the 253 nr-axSpA patients that switched from their previous biologic, physicians reported that 44.3% switched due to condition worsening, 37.9% had a loss of response over time, 22.5% switched due to an initial lack of response, and 18.2% of patients switched because remission was not induced.

CONCLUSIONS

Around two-thirds of nr-axSpA patients were receiving biologic therapy. Switching of biologics is frequent in nr-axSpA patients and is usually due to lack of efficacy, loss or response, and effort to accomplish remission.