Background Patient’s and Physician’s Global Assessment of Disease Activity (PtGA and PhGA) are important measures in Spondyloarthritis (SpA), but often provide discordant results. Some data show that patient-physician discordance can result in patient poor adherence to treatment and healthcare costs in SpA.^[1]

Objectives We intended to assess the principal determinants of both PtGA and PhGA in SpA patients under biologic treatment.

Methods We performed a cross-sectional study, including patients with SpA under biologic treatment registered in the Rheumatic Diseases Portuguese Register (Reuma.pt), consecutively evaluated in a tertiary hospital center. Sociodemographic and clinical data were collected. PtGA and PhGA were measured on a Visual Analogue Scale of 0-100.

To identify determinants of PtGA and PhGA, we performed firstly a univariate analysis with the independent variables and subsequently a multiple linear regression. SPSS v.24 was used for statistical analysis.

Results We evaluated 186 patients with SpA according to ASAS criteria, under biologic treatment. Most patients were male (53.20%) with a mean age of 52.15 (SD=12.9) years-old at the time of last medical appointment. PtGA and PhGA were significantly different. Clinical and laboratory characteristics of patients are shown in table 1.

There was a positive correlation between higher PtGA and older age, unemployment, number of tender joints, HAQ, HADS, BASDAI, number of comorbidities and daily medication. There was also an association with the concomitant presence of osteoarthrosis, fibromyalgia, C reactive protein (CRP), erythrocyte sedimentation rate (ESR) and daily prednisolone intake. On the other side, we found a negative correlation with SF-36, FACIT and EQ5D. The multiple linear regression shows that the SF-36 (p=0.001), BASDAI (p<0.001) and being unemployed (p=0.042) were the most preponderant determinants in PtGA explaining 85% of the variability noted in PtGA (R² = 0.846; R²_a= 0.828).

Regarding PhGA we found a positive correlation between the number of tender and swollen joints, CRP and daily prednisolone intake. In multivariable analyses the main determinants of PhGA were the number of swollen joints and higher CRP (R² = 0.867; R²_a= 0.829).

Conclusion We have demonstrated that comorbidities, employment status, and other factors not directly related to the disease are also determinants in PtGA. On the other hand, more objective data such as swollen joints and increased CRP were predominant in PhGA construct.

Reference [1]Desthieux, C., Molto, A., Granger, B., Saraux, A., Fautrel, B., & Gossec, L. (2016). Patient-physician discordance in global assessment in early spondyloarthritis and its change over time: the DESIR cohort. Annals of the rheumatic diseases, 75(9), 1661–1666. https://doi.org/10.1136/annrheumdis-2015-208251.

Acknowledgements: NIL.

Disclosure of Interests None Declared.