الملخص الإنجليزي
Objectives: We sought to identify the predictors of not achieving remission or low disease
activity (LDA) among axial spondyloarthritis (SpA) patients in four Middle Eastern
countries. Methods: In this multicenter prospective real-world study, adult patients with
axial SpA diagnosed clinically during January–June 2019, and who met the Assessment of
SpondyloArthritis International Society classification criteria for axial SpA, were enrolled
from the participating centers of four countries—Lebanon, Oman, Qatar, and the UAE.
Patient demographics, disease history, comorbidities, treatment, and compliance data
were obtained at baseline. The primary outcome was to determine the percentage of patients
who did not achieve the clinical target of remission or LDA as indicated by Ankylosing
Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP) < 2.1 after a threemonth follow-up period. Secondary outcomes were assessing the demographic and clinical
characteristics of 'achievers' and 'non-achievers' and to study the predictors of ASDASCRP ≥ 2.1 in different clinical subsets. Results: The participants were 309 patients of
both sexes, with a median age of 43 years. Women had a slight majority (53.7%). At
the end of the study, 72.2% of patients achieved the clinical target of ASDAS-CRP
< 2.1. Non-achievers were significantly more likely to have enthesitis, positive human
leukocyte antigen B 27 status, psoriasis, peripheral involvement, fibromyalgia, and a lower
score on Compliance Questionnaire for Rheumatology (CQR). Multiple regression
analysis showed that low CQR score, enthesitis, psoriasis, and family history of SpA
were independent predictors of ASDAS-CRP ≥ 2.1. Conclusions: This real-world study
suggests that low compliance, positive human leukocyte antigen B 27 status, peripheral
involvement, and presence of enthesitis, psoriasis, and fibromyalgia are predictors of not
achieving remission or LDA in axial SpA patients.
