AB1160 A BENCHMARKING STUDY EVALUATING THE BURDEN OF AXIAL SPONDYLOARTHRITIS IN SPAIN COMPARED WITH THE REST OF EUROPEAN COUNTRIES. RESULTS OF THE SPANISH ATLAS AND EMAS STUDIES.
Authors: M. Garrido-Cumbrera, E. Collantes-Estévez, V. Navarro-Compán, P. Zarco Montejo, C. Sastré, S. Sanz-Gómez, P. Plazuelo-Ramos, J. Gratacos-Masmitja
Journal: Annals of the Rheumatic Diseases (2020)

Background: Benchmarking studies in axial spondyloarthritis (axSpA) may provide evidence of disparities, making it necessary to improve the healthcare and management of these patients. Objectives: To evaluate differences between Spain and the rest of Europe (RoE) in relation to sociodemographic characteristics, life habits, and patient-reported outcomes (PROs) in axSpA patients. Methods: Data from 2,846 unselected patients from the European Map of Axial Spondyloarthritis (EMAS) were collected through an online survey, with a comparative analysis of 680 Spanish patients (2016) and 2,166 patients living in 12 other European countries (2017-2018). Socio-demographic characteristics, life habits, and PROs [BASDAI (0-10), spinal stiffness (3-12), and psychological distress (0-12, General Health Questionnaire GHQ-12)] were compared. The Χ 2 test was used for qualitative variables and the Mann-Whitney test applied for quantitative variables. Results: Data from 680 (23.9%) Spanish patients were compared to 2,166 (76.1%) patients from the RoE. Compared to Spain, the RoE patients reported a higher percentage of females (64.1% vs 52.5%; p&lt;0.001), university studies (51.7% vs 36.9%; p&lt;0.001) and higher income per family member (€1,173.5 vs €823.2; p&lt;0.001). In Spain, the proportion of respondents who were members of patient associations was higher than in RoE (44.3% vs 37.2%; p&lt;0.001) (Table 1). Also compared to RoE, Spanish patients showed a greater diagnostic delay (8.5±7.7 vs 7.2±8.6; p&lt;0.001), HLA-B27 carriership (77.1% vs 70.1%; p=0.003), and disease activity (5.7±2.0 vs 5.4±2.0; p=0.024). Despite lower diagnosis of anxiety and depression rates, Spanish patients reported greater psychological distress (5.7±4.5 vs 4.8±4.0; p&lt;0.001). However, RoE patients declared greater spinal stiffness compared to Spanish patients (7.8±2.4 vs 7.5±2.7; p=0.009) (Table 2). Table 1. Comparison of socio-demographic characteristics and lifestyle habits of axSpA patients in Spain and in RoE Spain (n = 680) Mean ± SD; n (%) RoE (n = 2,166) Mean ± SD; n (%) p-value Age (Years) 45.7 ± 10.8 43.4 ± 12.6 &lt;0.001* Gender (Female) 357 (52.5) 1389 (64.1) &lt;0.001* Educational level - No schooling 9 (1.3) 23 (1.1) &lt;0.001* - Primary school 119 (17.5) 144 (6.6) - High school 301 (44.3) 880 (40.6) - University 251 (36.9) 1,119 (51.7) Monthly income (€) per household member 823.2 ± 656.4 1,173.5 ± 928.8 &lt;0.001* Smoking - Non-smoker or socially 417 (71.3) 1,679 (77.5) &lt;0.001* - Less than 10 cig/day 24 (4.1) 111 (5.1) - More than 10 cig/day 144 (24.6) 376 (17.4) Alcohol - Never or occasionally 503 (86.0) 1,723 (79.5) &lt;0.001* - 1–2 times per week 37 (6.3) 292 (13.5) - More than 2 per week 45 (7.7) 151 (7.0) Member of a patient support group 301 (44.3) 806 (37.2) 0.001* Table 2. Comparison of PROs of axSpA patients between Spain and RoE Spain (n = 680) Mean ± SD; n (%) RoE (n = 2166) Mean ± SD; n (%) p value Diagnostic delay, years 8.5 ± 7.7 7.2 ± 8.6 &lt;0.001* HLA-B27 (positive) 391 (77.1) 892 (70.1) 0.003* BASDAI (0–10) 5.7 ± 2.0 5.4 ± 2.0 0.024* Spinal Stiffness (3–12) 7.5 ± 2.7 7.8 ± 2.4 0.009* GHQ-12 (0–12) 5.7 ± 4.5 4.8 ± 4.0 &lt;0.001* Anxiety 135 (19.9) 674 (33.1) &lt;0.001* Depression 100 (14.7) 610 (30.0) &lt;0.001* Conclusion: In this study, significant differences between Spanish and RoE patients were observed for the burden of the disease in patients with axSpA. Patients in Spain experience a greater diagnostic delay and greater psychological distress. Acknowledgments: Funded by Novartis Farmacéutica S.A. Disclosure of Interests: Marco Garrido-Cumbrera: None declared, Eduardo Collantes-Estévez Grant/research support from: ROCHE and Pfizer., Speakers bureau: ROCHE, Lilly, Bristol and Celgene., Victoria Navarro-Compán Consultant of: Abbvie, Lilly, Novartis, Pfizer, UCB, Speakers bureau: AbbVie, MSD, Lilly, Novartis, Pfizer, UCB, Pedro Zarco Montejo Grant/research support from: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Speakers bureau: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Carlos Sastré Employee of: YES; I´m Medical Advisor in Novartis Spain, Sergio Sanz-Gómez: None declared, Pedro Plazuelo-Ramos: None declared, Jordi Gratacos-Masmitja Grant/research support from: a grant from Pfizzer to study implementation of multidisciplinary units to manage PSA in SPAIN, Consultant of: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Speakers bureau: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly