Residual Disease Activity and Burden of Disease in Canadian Patients With Axial Spondyloarthritis: Results From a Multiregistry Analysis (UNISON-Axial SpA)
Bibliographic record
Abstract
OBJECTIVE: There is a key knowledge gap in quantifying residual disease activity in Canadian patients with axial spondyloarthritis (axSpA). The objective of this study was to evaluate and describe residual disease activity and burden of disease in Canadian patients with axSpA. METHODS: This was an observational, retrospective analysis of data extracted from the Rhumadata (Québec), Spondyloarthritis Research Consortium of Canada (SPARCC; East/Atlantic and West regions, as well as Ontario), and Follow-up Research Cohort of Ankylosing Spondylitis (FORCAST; Alberta) registries. The primary endpoint was the proportion of patients who failed to achieve sustained low disease activity (LDA) at 12 months. LDA was defined as a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score < 3 and sustained LDA was defined as achieving LDA at both 6 and 12 months after the most recent change in treatment. Analyses included outcomes by treatment class (nonsteroidal antiinflammatory drugs, tumor necrosis factor inhibitor, or interleukin 17 inhibitor). RESULTS: A total of 980 patients (Rhumadata, N = 488; SPARCC, N = 239; FORCAST, N = 253) were included. Nearly half of patients with axSpA from Rhumadata (49.5%) and FORCAST (55.3%) and 65.8% of those from SPARCC failed to achieve LDA (BASDAI < 3) at 6 months after treatment initiation. At 12 months, failure to achieve sustained LDA rose to 62% in Rhumadata, 65.1% in FORCAST, and 81% in SPARCC. Pain persisted in nearly half of all patients. CONCLUSION: This analysis demonstrated that most Canadians with axSpA failed to achieve sustained LDA after 12 months of initiating their latest therapy and confirms a high unmet need for additional treatments.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.006 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".