Clinical characteristics, comorbidities, and disease activity outcomes in a Saudi Arabian axial spondyloarthritis...

Real-world data on axial spondyloarthritis from Saudi Arabia remain limited. We described the demographic and clinical characteristics, comorbidity burden, cumulative advanced-therapy exposure, and 12-month disease activity outcomes of a Saudi tertiary-care axial spondyloarthritis cohort.

We conducted a retrospective single-center cohort study including 148 patients who fulfilled international classification criteria for axial spondyloarthritis and had sufficient clinical data for analysis, including paired baseline and 12-month (mean 12.2 ± 1.1 months) ankylosing spondylitis disease activity score based on C-reactive protein (ASDAS-CRP) values. Baseline was defined as the index treatment episode anchoring the paired baseline-to-12-month ASDAS-CRP assessment. Outcomes were summarized descriptively; clinically important and major improvement was defined as decreases in ASDAS-CRP of at least 1.1 and 2.0 units, respectively.

Mean age was 41.0 ± 12.8 years, 64.9% were male, and mean diagnostic delay was 4.3 ± 3.3 years. HLA-B27 was positive in 62.8%, numerically more often in ankylosing spondylitis than in nonradiographic disease (73.8% vs 48.4%) and in men than in women (68.8% vs 51.9%). Peripheral arthritis, enthesitis, uveitis, psoriasis, and inflammatory bowel disease occurred in 39.9%, 41.2%, 17.6%, 14.9%, and 9.5%, respectively. Mean ASDAS-CRP improved from 3.30 ± 0.64 to 2.06 ± 0.66; 50.7% achieved clinically important improvement, 17.6% major improvement, and 67.6% a score below 2.1.

This study provides important real-world data from a large Saudi tertiary-care cohort on axial spondyloarthritis phenotype, comorbidity burden, cumulative advanced-therapy exposure, and 12-month outcomes. 67.6% of patients reached a practical disease activity target (ASDAS-CRP < 2.1), although inactive disease was achieved by a smaller subgroup (14.2%). Key Points • This study represents one of the largest published single-center Saudi cohorts of patients with axial spondyloarthritis. • Patients in this tertiary-care cohort had documented musculoskeletal, extra-musculoskeletal, and comorbidity burden, together with advanced-therapy exposure. • At 12 months, mean ASDAS-CRP decreased from 3.30 to 2.06, and 67.6% of patients achieved ASDAS-CRP < 2.1, although inactive disease was reached by a smaller subgroup.