Determinants associated with the prescription of a first biologic therapy in patients with axial spondyloarthritis and concomitant fibromyalgia in daily practice - 24/11/24
Highlights |
• | Fibromyalgia (FM) is often associated with spondyloarthritis (SpA) and impacts the assessment of SpA activity. There is no consensus on the decision of rheumatologists to prescribe a first biologic DMARD (bDMARD) in patients with SpA and concomitant FM. |
• | According to a mixed (qualitative and quantitative) approach, this cross-sectional survey-based study identified four consensual criteria contributing to the decision of rheumatologists to prescribe a first bDMARD in patients with a diagnosis of SpA/FM. Most criteria were more related to an approach aimed at ensuring the diagnosis of SpA than evaluating its activity or severity. Beyond this, rheumatologists relied on their clinical expertise, their judgment based on practice and experience, and on psychological factors. |
• | The management in real-life practice of SpA/FM is different to that of SpA alone. In case of the same level of activity of the two diseases, they are treated concomitantly by the majority of rheumatologists. |
Abstract |
Objectives |
There is no consensus on the therapeutic strategy of rheumatologists for patients with spondyloarthritis (SpA) and concomitant fibromyalgia (FM). The main aim of this study was to identify, in a population of rheumatologists practicing in Normandy, France, the determinants associated with their decision to prescribe a first biologic DMARD (bDMARD) in patients with Spa/FM. Specific objectives were to evaluate professional prescribing practices to identify a set of criteria likely to contribute to the therapeutic decision of rheumatologists, and to validate the relevance of these criteria.
Method |
This is a cross-sectional survey-based study using a mixed (qualitative and quantitative) method. The quantitative approach was web-based and conducted among rheumatologists in Normandy.
Results |
The qualitative study allowed us to identify a set of criteria likely to contribute to the therapeutic decision of rheumatologists. In the quantitative study, 54/113 rheumatologists filled the questionnaire. Four criteria were considered by all respondents to contribute to their decision to prescribe a first bDMARD: arthritis on physical examination, extra-articular manifestations, systemic inflammation and structural damage on imaging.
Conclusions |
The determinants associated with the decision of rheumatologists to prescribe a first bDMARD in patients with SpA/FM were mostly objective, in line with the recommendations in the literature. Most criteria were more related to an approach aimed at ensuring the diagnosis of SpA than evaluating its activity or severity.
Le texte complet de cet article est disponible en PDF.Keywords : Spondyloarthritis, Fibromyalgia, Biologic DMARD, Therapeutic strategy, Surveys and questionnaires, Qualitative study, Quantitative study
Plan
Vol 91 - N° 6
Article 105773- décembre 2024 Retour au numéro
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