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Background: Axial spondyloarthritis (AS) is an autoinflammatory disease in which biologic or targeted synthetic disease modifying drugs (DMARDs) therapy is widely used, with several targets and drugs to chose from. However, some patients are still somewhat refractory to the therapies that are provided to them. Objectives: To analyse the clinical and therapeutic characteristics in AS patients who have received at least three distinct advanced therapy (AT) lines. Methods: This is a retrospective longitudinal observational study of AS patients treated with at least 1 targeted therapy (TT). We analyse the different therapeutic lines administered, their duration and the causes of withdrawal. The patients are classified in non-refractory AS –those who have received up to 2 lines of TT– and refractory AS –those who have received 3 or more lines of therapy–. Results: 162 AS patients with TT treatment where included (62.4% men), with a mean age at diagnosis of 41 (13) years and a disease progression time since the beginning of the first TT of 20 (30) months. 59.1% of patients were HLA-B27 positive, 20.5% presented extraarticular manifestations (uveitis and/or inflammatory bowel disease) and 38.3% presented peripheral damage. 10 people required 3 or more different lines of therapy. In those patients, drug survival is shorter (PTable 1. Table 2. Conclusion: 6% of our AS patients required the use of at least 3 therapeutic families, with a mean of 4 lines of TT. The treatment with anti-TNF is less used in first and second line in patients who have required at least 3 therapeutic families, and the treatments are mainly modified through switching rather than cycling. The presence of other factors –such as psoriasis or anxious-depressive syndrome– seem to be associated with patients who require 3 or more therapeutic lines. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.
Álvarez-Ellacuria et al. (Sat,) studied this question.