Poorly and well controlled spondyloarthropathies: a comparison of 2 groups of patients

To describe in a large population of patients with spondyloarthropathy (SpA) the proportion and characteristics of individuals whose disease was poorly controlled by their current treatment, compared to patients whose disease was well controlled.

We conducted a survey among the members of Spondylis, one of the main not-for-profit SpA patient organizations in France. One thousand anonymous questionnaires were sent to patients throughout France. Among collected data were the opinions of patients about control of their symptoms as well as their past and current treatment.

Five hundred and seven respondents were included in the study of whom 75.9% were receiving nonsteroidal antiinflammatory drugs (NSAID), 55% reported inadequate control, and 45% good control of their nocturnal pain and morning stiffness. The Bath Ankylosing Spondylitis disease activity index (BASDAI) and functional index (BASFI) scores and the rates of occurrence of main symptoms were significantly higher in the group with poorly controlled disease. All drugs except NSAID were more often used currently and in the past by patients with poor disease control.

Conventional treatments failed to provide adequate symptom relief in over half the patients with SpA, despite the use of various drugs in the vast majority of them. Although our results were obtained in a selected patient population, they suggest that a rather large proportion of SpA patients might be candidates for biotherapies.