November 10, 2022
Further Education Needed for the Proper Diagnosis of Ankylosing Spondylitis and Non-Radiographic Axial Spondyloarthritis in the EU5, Spherix Global Insights Reports
Referrals from primary care physicians to rheumatologists are being delayed due to several factors
EXTON, Pa., November 10, 2022 /PRNewswire/ – Rheumatologists in the EU5 (France, Germany, Italy, Spain, and the United Kingdom) recognize a disconnect in the diagnosis and referral process for ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA) patients. The lack of education, awareness of symptoms, and necessary tools needed to properly diagnose these patients has delayed referrals from primary care physicians to rheumatologists.
Spherix Global Insights (“Spherix”) conducted its inaugural EU5 study of AS and nr-axSpA treatment landscape through their RealTime Dynamix™ service in July 2022, which provided insights on patient management and market trends from rheumatologists within the EU5 region.
Rheumatologists rely on a number of tests and imaging to diagnosis suspected axSpA (axial spondyloarthritis) patients under their care – most notably the use of X-rays and MRIs. However, when analyzing what imaging tests were run prior to their axSpA patients being referred to them, study results show only half of suspected patients had an X-ray performed, and fewer had obtained an MRI.
Given how important these tests are for diagnosis, it comes as no surprise that referring physicians are often not able to identify the correct condition for these patients before they go on to see a rheumatologist. In fact, only one-quarter of AS patients were referred with the correct diagnosis, which dropped to one-tenth among those with nr-axSpA. Most referred patients were either suspected to have the condition or misdiagnosed, with the latter being more common among nr-axSpA patients.
Most rheumatologists in the Spherix study agree that primary care physicians are not educated on the symptoms associated with spondyloarthritis, a possible explanation for why X-ray and MRI testing is often not performed. Another key issue raised by surveyed rheumatologists is the fact that only a fraction of patients with AS and nr-axSpA are referred to them, noting some primary care physicians are attempting to treat these axSpA patients.
As stated in a recent article from RheumNow on EULAR’s recently updated guidelines for axSpA management, early diagnosis for these patients is encouraged in order to slow down disease progression. However, it’s been recommended to reconsider diagnoses and comorbidities of patients who are not responding to treatment. Given the prevalence of misdiagnoses for spondyloarthritis patients, it is important to obtain an accurate diagnosis and develop a treatment plan to prevent further joint damage as early as possible.
The typical treatment approach for a mild AS and nr-axSpA patient is to use NSAIDs, with patients staying on these agents for approximately eight to nine months before switching to or adding on a more advanced therapy. Once the patient progresses to moderate disease severity, rheumatologists will introduce biologics and JAK inhibitors into the patient’s treatment, according to the RealTime Dynamix™ report.
In accordance with the updated EULAR Guidelines, TNF inhibitors are typically the first biologic AS and nr-axSpA patients are initiated on across both indications. Half will be cycled to another TNF agent at second line, while IL-17 inhibitors are the leading alternate MOA in the second- or later-line setting. JAK inhibitors represent a small portion of third- or later-line share across indications.
The need for further education on the symptoms associated with AS and nr-axSpA, as well as the testing required for an accurate diagnosis, are paramount for proper management and treatment of these conditions.
About RealTime Dynamix™
RealTime Dynamix™ is an independent service providing strategic guidance through quarterly or semiannual reports, which include market trending and a fresh infusion of event-driven and variable content with each wave. The reports provide an unbiased view of the competitive landscape within rapidly evolving specialty markets, fueled by robust HCP primary research and our in-house team of experts.
About Spherix Global Insights
Spherix Global Insights is a hyper-focused market intelligence firm that leverages our own independent data and expertise to provide strategic guidance, so biopharma stakeholders make decisions with confidence. We specialize in select dermatology, gastroenterology, nephrology, neurology, ophthalmology, and rheumatology markets.
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