Do patients with axial spondyloarthritis with active disease suffer from greater disease burden and work impairment? Results from the International Map of Axial Spondyloarthritis (IMAS)
Bibliographic record
Abstract
To assess the prevalence of clinically active disease in axial spondyloarthritis (axSpA) and its associated factors in a large global sample of patients from the International Map of Axial Spondyloarthritis (IMAS) study. IMAS is a cross-sectional online survey (2017–2022) of 5557 axSpA patients. Patients were divided between those with active disease (BASDAI ≥4) and without active disease (BASDAI <4). The factors evaluated were sociodemographic, lifestyle, patient-reported outcomes, employment, disease characteristics, extra-musculoskeletal manifestations, and treatment. Logistic regression analysis stratified by gender were used to evaluate the relationship between investigated factors and active disease. In the present study, 5295 patients who had responded to the BASDAI scale were included in the present study: 3231 were from Europe, 770 from North America, 600 from Asia, 548 from Latin America, and 146 from Africa. The mean age was 43.8 ± 12.9 years and 55.4% were females. Patients reported a mean BASDAI of 5.4 (±2.1) with 75% having active disease (BASDAI ≥4). In South Africa, 87.0% of patients reported having active disease, compared to 68.5% in Asia. Multivariable logistic regression showed an association of active disease with higher functional limitation, greater spinal stiffness, difficulty finding a job due to axSpA and worse mental health in both genders. For males, younger age and shorter diagnostic delay, and for females, no physical activity and presence of inflammatory bowel disease were associated with active disease. Three quarters of patients with axSpA reported clinically active disease, with higher proportion of patients with active disease in South Africa and lower proportion in Asia. Our results underline the complexity of the clinical disease activity concept in axSpA and the need for a holistic approach in the patient management, care and treatment. Evaluar la prevalencia de la enfermedad clínicamente activa en la espondiloartritis axial (EspA-ax) y sus factores asociados en una gran muestra global de pacientes del estudio Mapa Internacional de la Espondiloartritis Axial (IMAS). IMAS es una encuesta transversal online (2017-2022) de 5557 pacientes con EspAax. Los pacientes se dividieron entre aquellos con enfermedad activa (BASDAI ≥4) y sin enfermedad activa (BASDAI <4). Los factores evaluados fueron sociodemográficos, estilo de vida, resultados comunicados por los pacientes, empleo, características de la enfermedad, manifestaciones extraesqueléticas y tratamiento. El análisis de regresión logística estratificado por sexo permitió evaluar la relación entre los factores investigados y la enfermedad activa. En el presente estudio se incluyeron 5.295 pacientes con EspAax que habían respondido a la escala BASDAI: 3.231 procedían de Europa, 770 de Norteamérica, 600 de Asia, 548 de Latinoamérica y 146 de África. La edad media era de 43,8 ± 12,9 años y el 55,4% eran mujeres. Los pacientes declararon un BASDAI medio de 5,4 (±2,1), y el 75% tenía la enfermedad activa (BASDAI≥4). En Sudáfrica, el 87,0% de los pacientes declararon tener la enfermedad activa, frente al 68,5% en Asia. La regresión logística multivariable mostró una asociación de la enfermedad activa con una mayor limitación funcional, mayor rigidez de la columna vertebral, dificultad para encontrar trabajo debido a la EspAax y peor salud mental en ambos sexos. En el caso de los varones, la menor edad y el menor retraso diagnóstico y en el caso de las mujeres, la ausencia de actividad física y la presencia de enfermedad inflamatoria intestinal se asociaron con la enfermedad activa. Tres cuartas partes de los pacientes con EspAax declararon enfermedad clínicamente activa, con mayor proporción de pacientes con enfermedad activa en Sudáfrica y menor proporción en Asia. Nuestros resultados subrayan la complejidad del concepto de actividad clínica de la enfermedad en la EspAax y la necesidad de un enfoque holístico en la gestión, la atención y el tratamiento de los pacientes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".