Abstract Background/Aims: Background Axial Spondyloarthritis (AxSpA) is a chronic inflammatory rheumatic disease affecting the axial skeleton that can cause both extra musculoskeletal (EMMs) and extra articular manifestations (EAMs) (Wright et al 2020). Nurse-led care (NLC) has demonstrated non-inferiority to consultant-led care in Rheumatoid Arthritis patient cohorts for over a decade (Ndosi et al, 2014, Lopatina et al, 2021), with a paucity of data in comparable inflammatory diseases. Treatment with non-steroidal anti-inflammatory drugs (NSAIDs), physiotherapy, and biologic medications have been the standard of care. While ASAS guidelines recommend multidisciplinary care, nursing input is not specifically referred to in this guidance (Ramiro et al, 2023), however the EULAR recommendations for role of the nurse in management of chronic inflammatory arthritis advocates for shared decision making between nurse and patient, and timely access to nursing care (Bech et al, 2020). Aim To demonstrate efficacy of NLC for AxSpA patients through year 1 post diagnosis; by demonstrating reduction in patient reported outcome measures/ NSAID use and maximising treatment persistence. Methods Following confirmation of AxSpA diagnosis, patients were referred to join the NLC pathway. Across 3/4 appointments, outcome measures were collected and patients received education about their diagnosis and management plan, trial of minimum 1 NSAID and/or biologic initiation/ switch where appropriate, EMMs/ EAMs assessment, comorbidity screening, lifestyle (including family planning) and vaccine advice to reduce infection risk and medication reconciliation. Patients were referred for physiotherapy at their closest centre to home as per Slaintecare recommendations, and if appropriate were encouraged to stop smoking. Results From January-December 2024, 60 patients enrolled with an average age at diagnosis of 38 years. 60% (36) of patients were male, and of the sixty patients, 77% (46) attended minimum 3 visits. NSAID use reduced from 50% regular use at visit 1 to 68% rare use by visit 3. Biologic use was maintained at 80% across visit 2 and 3, with 70% (42) same biologic persistence achieved. 53% (32) confirmed physiotherapy review by visit 2. Average outcome measures at each visit are as follows; Visit 1 BASDAI 4.53, BASFI 3.71, BAS-G 5.41, BASMI 2.92; Visit 2 BASDAI 3.55, BASFI 2.72, BAS-G 4.26, BASMI 2.55; and Visit 3 BASDAI 3.50, BASFI 2.80, BAS-G 3.57, BASMI 2.30. Further analysis is ongoing. Conclusion NLC has been shown to have a positive impact on a number of relevant patient outcomes in this cohort. Challenges included maintaining dedicated clinic time which is essential to meeting review deadlines, and changes have been made locally while data collection is ongoing. While further research is needed to confirm non-inferiority to consultant-led care, we propose that AxSpA patients are a suitable cohort for NLC. Disclosure E. Shinners: Honoraria; ES has received honaria from Roche, Pfizer, Johnson ES has received unrestricted educational grant from Johnson & Johnson. A. Gorman: None.
Shinners et al. (Wed,) studied this question.