THU0386 CHILEAN AXIAL SPONDYLOARTHRITIS PATIENTSREPORT HIGH DISEASE BURDEN AND IMPAIRED WORK ACTIVITY – AN INTERNET SURVEY IN 472 PATIENTS
Authors: Sebastian Ibáñez, Rianne van Bentum, Omar Valenzuela, Irene van der Horst-Bruinsma
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Axial spondyloarthritis (axSpA) can be associated with significant burden and impaired work activity. In Chile, several barriers impede adequate treatment, such as insufficient access to specialists and biological treatment. Furthermore, there is an important lack of insight into the local situation. This hampers the development of adequate national treatment standards and financial support. <h3>Objectives</h3> 1. To evaluate the disease burden, quality of life and work participation in Chilean axSpA patients. 2. To assess gender differences in disease burden and 3) compare patients with and without biologics. <h3>Methods</h3> A cross sectional online survey among Chilean SpA patients, recruiting via the internet website and associated social media of the Chilean SpA Patient Foundation ("Espondilitis Chile"). The survey was written in Spanish and requested information, mostly via multiple choice options, on gender, age, disease characteristics (diagnosis, disease duration, treatment), disease burden (BASDAI and BASFI), quality of life (ASAS Health Index) and work participation (WPAI). Only axSpA patients were included for further analyses. The association between BASDAI, quality of life or work participation (presenteeism, absenteeism) and subgroups (gender, biologics) was assessed through univariable regression and subsequently multivariable regression analyses, correcting for age, disease duration and concomitant treatment (NSAIDs, DMARDs, opiates). <h3>Results</h3> Between July and October 2018, 625 patients completed the website survey, of whom 472 reported a diagnosis with axSpA (91% radiographic axSpA, 37% male, mean age 42 years, 83% BASDAI≥4, table 1). Twenty percent used a biological and patients with biologics were more likely to have a paid job (p=0.01) and had significantly lower BASDAI, BASFI, ASAS HI and risk of absenteeism. In multivariable analyses, biologics remained significantly associated with a lower BASDAI. Interestingly, biologics were used significantly more often in male patients compared to females (26% versus 16%, p&lt;0.01), while BASDAI, ASAS HI and chance of absenteeism and presenteeism were significantly higher in female patients (table 1). After correction for treatment, the gender difference in BASDAI, absenteeism and presenteeism was not significant anymore. <h3>Conclusion</h3> The results of the web survey demonstrate a high level of disease burden and work impairment in Chilean axSpA patients. The use of biologics is low, although its use is independently associated with having a lower disease activity. Women used significantly less biologics despite reporting a worse disease state (BASDAI, ASAS HI) and greater work disability, suggesting inequality in access to treatment. <h3>Acknowledgement</h3> This study was conducted with help of the Chilean spondyloarthritis patient foundation "Espondilitis Chile". <h3>Disclosure of Interests</h3> Sebastian Ibáñez Consultant for: Novartis, Paid instructor for: Bristol Myers Squibb, Speakers bureau: Abbvie, Rianne van Bentum: None declared, Omar Valenzuela Consultant for: Novartis, Paid instructor for: Bristol Myers Squibb, Speakers bureau: Abbvie, Irene van der Horst-Bruinsma Grant/research support from: MSD, Pfizer, AbbVie, Consultant for: Abbvie, UCB, MSD, Novartis, Speakers bureau: BMS, AbbVie, Pfizer, MSD