Published Clinical Papers 2021

Below is a round up of the top research stories in 2021.

Women of childbearing age living with spondyloarthritis: time for improving knowledge and counselling about reproductive issues 

A systematic literature review and meta-analysis looked at the issues around pregnancy and fertility for people with spondyloarthritis. The review found just four studies relating to fertility and so they were unable to draw any conclusions. They did find that symptoms generally remained quite stable during pregnancy although there was a worsening of symptoms in the second trimester. The paper highlights the need for more research in this area.

Sex-associated and gender-associated differences in the diagnosis and management of axial spondyloarthritis: addressing the unmet needs of female patients

This meta analysis of 42 papers looked at the differences in female patients and importantly their unmet needs. The study showed that female patients experience a longer diagnostic delay compared with male patients; therefore, better and earlier identification of signs and symptoms of axial SpA according to sex is needed. The response to treatment with biologic therapies should be considered and women should be educated on the relevance of lifestyle factors and benefits of regular physical exercise, maintenance of a normal body weight and smoking cessation . Women of childbearing age living with axial SpA should be receive counselling about the use of biological agents during pregnancy and breastfeeding and be able to have .

Changes in ankylosing spondylitis incidence, prevalence and time to diagnosis over two decades

This population-based study, conducted in the UK across two decades and including 12 333 patients diagnosed with ankylosing spondylitis (AS), showed a decrease in the incidence of AS among men and a rise in prevalence, especially in the over 60s. The observed lack of improvement in diagnostic delay over a 20-year period, appeared to be largely driven by delay in referral from primary care to rheumatology.

These results highlight the need to promote the recognition of inflammatory back pain among all health practitioners evaluating people with back pain, and to encourage referral of suspected axial SpA cases to rheumatology.

Diagnostic delay is common for patients with axial spondyloarthritis: results from the National Early Inflammatory Arthritis Audit

The National Early Inflammatory Arthritis Audit collects data on people who are referred to rheumatology with suspected inflammatory arthritis, including axial SpA. In this paper the authors explore the initial results from the audit on the time from when people show symptoms to when they are first diagnosed and education on the condition. The results showed that people with axial SpA waited longer than rheumatoid arthritis for a diagnosis and received less education.

Delayed diagnosis in axial spondyloarthritis—how can we do better?

Dale Webb along with Karl Gaffney and Raj Sengupta looked further into the results from the National Early Inflammatory Arthritis Audit. This piece considers what the barriers may be to getting a diagnosis but also offers some solutions, referencing the Act on Axial SpA campaign led by NASS.

Diagnostic delay in axial spondyloarthritis: a systematic review and meta-analysis

A review was conducted using a variety of research websites to look at what the mean average delay in diagnosis is across studies in axial SpA. The results showed that the time to diagnosis is still too high, with high income countries fairing worse than middle-income.

To move or not to move: the paradoxical effect of physical exercise in axial spondyloarthritis

Animal models demonstrated that physical strain and stress could have an impact on inflammation in the joints and tendons and even new bone formation. This study shows the importance of exercise and how it is an integrated part of life with axial SpA but that people should be cautious when choosing the types of exercise they do.

Poor health and functioning in patients with axial spondyloarthritis during the COVID-19 pandemic and lockdown: REUMAVID study (phase 1)

The REUMAVID study looked at the impact of lockdown on people with rheumatic conditions and was advertised by NASS. A significant amount of people found that lockdown had made their general health and axial SpA much worse.