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Background: Despite advances in the treatment of rheumatoid arthritis (RA) and the wide range of therapies available, there is a percentage of patients whose treatment presents a challenge for clinicians due to lack of response to multiple biologic and target-specific disease-modifying antirheumatic drugs (b/tsDMARDs)., Objective: To develop and validate an algorithm to predict multiple failure to biological therapy in patients with RA., Design: Observational retrospective study involving subjects from a cohort of patients with RA receiving b/tsDMARDs., Methods: Based on the number of prior failures to b/tsDMARDs, patients were classified as either multi-refractory (MR) or non-refractory (NR). Patient characteristics were considered in the statistical analysis to design the predictive model, selecting those variables with a predictive capability. A decision algorithm known as 'classification and regression tree' (CART) was developed to create a prediction model of multi-drug resistance. Performance of the prediction algorithm was evaluated in an external independent cohort using area under the curve (AUC)., Results: A total of 136 patients were included: 51 MR and 85 NR. The CART model was able to predict multiple failures to b/tsDMARDs using disease activity score-28 (DAS-28) values at 6 months after the start time of the initial b/tsDMARD, as well as DAS-28 improvement in the first 6 months and baseline DAS-28. The CART model showed a capability to correctly classify 94.1% NR and 87.5% MR patients with a sensitivity = 0.88, a specificity = 0.94, and an AUC = 0.89 (95% CI: 0.74-1.00). In the external validation cohort, 35 MR and 47 NR patients were included. The AUC value for the CART model in this cohort was 0.82 (95% CI: 0.73-0.9)., Conclusion: Our model correctly classified NR and MR patients based on simple measurements available in routine clinical practice, which provides the possibility to characterize and individualize patient treatments during early stages., Competing Interests: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: D.P., C.T., V.R.-E., C.A.C., and M.D.-A. have nothing to declare. M.N.-N. reports grants from UCB, Lilly and Janssen outside the submitted work. D.B. reports grants from Roche, AbbVie, and Novartis outside the submitted work. A.V. reports grants from Janssen outside the submitted work. R.S. reports grants from Abbvie, BMS, Gebro-Pharma, Lilly, MSD, Pfizer, Sanofi, and Roche outside the submitted work. C.P.-R. reports grants from Abbvie, Pfizer, Novartis, Lilly and Roche outside the submitted work. A.B. reports grants from Abbvie, Amgen, Pfizer, Galapagos, Novartis, Gilead, BMS, Nordic, Sanofi, Sandoz, Lilly, UCB, and Roche outside the submitted work., (© The Author(s), 2022.)

Aim: To evaluate the overall health and functioning in patients with axial spondyloarthritis (axSpA) and related factors affecting these during the COVID-19 pandemic and lockdown measures., Methods: Data from 587 axSpA patients participating in the first phase (April-July 2020) of the REUMAVID study who completed the ASAS Health Index (ASAS-HI) were analysed. REUMAVID is a cross-sectional study that collects data through an online survey to assess the impact of the COVID-19 pandemic on patients with rheumatic and musculoskeletal diseases across seven European countries. Poor health was defined as ASAS-HI ⩾ 12. The World Health Organization Five well-being index, self-perceived health status and change in health status during COVID-19 pandemic were evaluated as secondary outcomes. Logistic regression models were used to identify the factors associated with poor health., Results: According to the ASAS-HI, 147 (25.0%) patients reported poor health. Pain and moving around were the main affected categories. In addition, 14.0% reported their self-perceived health status as 'bad' or 'very bad' and 46.8% as worse than before the pandemic. In the multivariate analysis, smoking (OR = 1.98), diabetes (OR = 4.89) and taking painkillers (OR = 2.82) or corticosteroids use (OR = 2.20) were significantly associated with poor health, while engaging in physical activity (OR = 0.54) and being actively employed (OR = 0.48) were inversely associated with this., Conclusions: During the first wave of the COVID-19 pandemic, one in four axSpA patients reported poor health and functioning, while the self-perceived health status of almost half of these patients worsened. Nonsmoking, physical activity and being employed were associated with better outcomes., Competing Interests: Conflict of interest statement: The authors declared the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: DB reports honoraria/research support from AbbVie, Novartis and Roche. CP received grants/speaker/research supports from Pfizer, Sanofi, Novartis, Roche and Lilly. HM have grants and/or honoraria from Abbvie, Celgene, Janssen, Elli-Lilly, MSD, Novartis, Pfizer and UCB. LC is an employee of Novartis Pharma AG. DW has received grant funding from AbbVie, Biogen, Janssen, Lilly, Novartis and UCB. VN-C reports honoraria/research support from AbbVie, BMS, Janssen, Lilly, MSD, Novartis, Pfizer, Roche and UCB., (© The Author(s), 2022.)

Background: Axial spondyloarthritis (axSpA) patients are known to have a higher prevalence of several comorbidities, including, among others, an increased risk of atherosclerosis, hypertension, dyslipidemia, and diabetes. The purpose of the present study was to determine whether the sum of traditional cardiovascular (CV) risk factors is related to disease characteristics, such as disease activity, in patients with axSpA., Methods: A cross-sectional study that encompassed 804 patients with axSpA was conducted. Patients were assessed for the presence of five traditional CV risk factors (diabetes mellitus, dyslipidemia, hypertension, obesity, and smoking status), and disease activity measurements. A multivariable regression analysis was performed to evaluate whether the number of classic CV risk factors was independently associated with specific features of the disease, to include disease activity., Results: A multivariable analysis showed that Ankylosing Spondylitis Disease Activity Score-C reactive protein (ASDAS-CRP) activity score was significantly higher in patients with 1 [beta coefficient 0.3 (95% confidence interval (CI) 0.1-0.5), p  = 0.001] and ⩾2 [beta coefficient 0.5 (95% CI 0.3-0.7), p  = 0.000] CV risk factors compared with those without CV risk factors. Similarly, patients with 1 [OR 2.00 (95%CI 0.99-4.02), p  = 0.053] and ⩾2 [OR 3.39 (95%CI 1.82-6.31), p  = 0.000] CV risk factors had a higher odds ratio for the presence of high disease activity compared with the zero CV category. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) activity score was significantly associated with the number of CV risk factors, being higher in patients with more CV risk factors. These relationships showed a CV risk factor-dependent effect being beta coefficients and ORs higher for the effect of ⩾2 over 1 CV risk factor., Conclusion: Among patients with axSpA, as the number of traditional CV risk factors increased, disease activity similarly increases in an independent manner., Competing Interests: Conflict of interest statement: MAG-G and IF-A would like to acknowledge that they received grants/research supports from Abbott, MSD, Jansen, and Roche, as well as consultation fees from company-sponsored speakers bureaus associated with Abbott, Pfizer, Roche, Sanofi, Celgene, and MSD., (© The Author(s), 2021.)

Aims: First, to compare clinical features and biological disease modifying anti-rheumatic drugs (bDMARDs) response in patients with axial spondyloarthritis (axSpA) and axial psoriatic arthritis (axPsA). Second, to identify possible predictors of treatment response in both entities., Methods: One-year follow-up, observational, single-center study including all patients with axSpA or axPsA who started bDMARDs therapy. Clinical features were collected at baseline while disease activity was measured at baseline, 6 and 12 months by the Ankylosing Spondylitis Disease Activity Score and the Physician Global Assessment. The frequency of patients achieving inactive disease (ID), low disease activity (LDA), high or very high disease activity and clinical improvement were compared between axSpA and axPsA. Baseline predictor factors for achieving treatment response were identified through regression models, using odds ratio (OR) as an estimate., Results: In total, 352 patients were included: 287 (81.5%) axSpA and 65 (18.5%) axPsA. No significant differences at baseline were observed between the two diseases for most of the characteristics. While HLA-B27 positivity was associated with axSpA (OR = 5.4; p  < 0.001), peripheral manifestations were associated with axPsA (OR = 4.7; p  < 0.001). The frequency of patients with axSpA and axPsA achieving ID/LDA after 6 and 12 months of bDMARDs was comparable: 53% versus 58%, p  = 0.5; and 58% versus 60%, p  = 0.9, respectively. Both diseases also presented similar clinical improvement. In axSpA and axPsA, male gender seemed to be associated with achieving LDA [OR at 12 months visit = 2.8 ( p  < 0.01) and 2.7 ( p  = 0.09)]., Conclusion: In clinical practice, patients with axSpA and axPsA present numerous similarities, including comparable medium-term clinical response to bDMARDs. Male gender could be a predictor of treatment response in both diseases.Keyword: axial spondyloarthritis, psoriatic arthritis, axial involvement, clinical characteristics., Competing Interests: Conflict of interest statement: DB received grants/speaker/research supports from Roche and Abbvie. CP received grants/speaker/research supports from Pfizer, Sanofi, Novartis, Roche and Lilly. RN received grants/speaker/research supports from Novartis, Sanofi Genzyme, Pfizer and Montpellier. IM received grants/research supports from Novartis and speaker’s fees from AbbVie, UCB, Roche and Novartis. DP received grants/research supports from Abbvie, Lilly, MSD and Roche, and had participation in company sponsored speaker’s bureau from Abbvie, Novartis, Lilly, Roche, and MSD. AB received grant/research support, fees for consultancies or as a speaker for Abbvie, Pfizer, Novartis, BMS, Nordic, Sanofi, Sandoz, Lilly, UCB, Roche. VN: consultancy/speaker/research grants from: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, UCB., (© The Author(s), 2020.)