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Predictors of remission in people with axial spondyloarthritis: A systematic literature review

Pinto, Ana Sofia; Farisogullari, Bayram; Machado, Pedro M; (2022) Predictors of remission in people with axial spondyloarthritis: A systematic literature review. Seminars in Arthritis and Rheumatism , 56 , Article 152078. 10.1016/j.semarthrit.2022.152078. Green open access

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Abstract

BACKGROUND: Achievement of remission is a desirable outcome and the identification of predictors of remission may aid in the clinical management of axial spondyloarthritis (axSpA). Our aim was to summarise predictors of remission in people with axSpA. METHODS: In this systematic literature review (SLR), we searched MEDLINE, EMBASE, and Cochrane CENTRAL from their inception to May 20, 2022, and 2020-2021 American College of Rheumatology (ACR) and European Alliance of Associations for Rheumatology (EULAR) meeting abstracts. We included randomized controlled trials and cohort studies in which prognostic factors associated with remission were investigated by multivariable analysis. RESULTS: The SLR comprised 21 articles from 4592 citations. Three studies investigated "sustained remission" (≥3 consecutive visits), while the other assessed "point remission" (at single points in time, varying from 12 weeks to 8 years). The most used remission criteria were Ankylosing Spondylitis Disease Activity Score (ASDAS) inactive disease (14 studies) and Assessment of SpondyloArthritis international Society partial remission criteria (11 studies). Younger age, HLA-B27 positivity, male gender, lower baseline Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), lower baseline Bath Ankylosing Spondylitis Functional Index (BASFI), lower baseline ASDAS-C-reactive protein, treatment with tumour necrosis factor inhibitors (TNFi), and concomitant use of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), were the most consistent predictors of remission. Additionally, shorter disease duration, lower Health Assessment Questionnaire for the spondyloarthropathies and TNFi naivety were predictors of remission in two studies. Other factors were found to be predictors of remission in one study only. CONCLUSIONS: Predictors of remission in axSpA were identified. However, many of these predictors were only identified in 1-2 studies. Considering the differences in study design, further well-designed prognostic studies are needed to confirm and allow generalisation of these predictors to the general axSpA population.

Type: Article
Title: Predictors of remission in people with axial spondyloarthritis: A systematic literature review
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.semarthrit.2022.152078
Publisher version: https://doi.org/10.1016/j.semarthrit.2022.152078
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Ankylosing spondylitis, Biological therapies, Predictors, Prognosis, Remission, Spondyloarthritis, Systematic review
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: https://discovery.ucl.ac.uk/id/eprint/10154920
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