P252 Treatment pathways for patients with axSpA: a retrospective UK database analysis

Abstract Background This UK study aimed to identify a population with axial spondyloarthritis (axSpA) and to describe the presence of prior reported symptoms and treatment pathways associated with the condition. Methods The study was performed using a large routine primary care database from the UK, the Clinical Practice Research Datalink. Only patients whose record could be linked to Hospital Episode Statistics (HES) were included for analysis. Patients with an incident diagnosis of axSpA recorded from 2003-2017 were identified. The date of first axSpA diagnosis defined the index date and patients were observed until the end of database follow up. Recordings of axSpA-related symptoms (back pain, rheumatoid arthritis and fatigue) in the 12 months prior to the index date, before and after attendance at orthopaedic or rheumatology outpatient clinics, and after inpatient contact with either a primary or secondary diagnosis of axSpA were flagged. The proportion of patients prescribed tumour necrosis factor inhibitors (TNFis), corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs) or conventional systemic disease-modifying anti-rheumatic drugs (csDMARDs) subsequent to the index date and estimated first three lines of therapy were described. Results A total of 2,756 incident axSpA cases were identified. In the 12 months prior to the index date, 1,289 (46.8%) of these patients had at least one recorded symptom related to axSpA: back pain (1,195 [43.4%]), rheumatoid arthritis (140 [5.1%]) and fatigue (6 [0.2%]). Prior to the index date, 1,025 (37.2%) patients had been seen in an orthopaedic outpatient clinic and 1,274 (46.2%) in a rheumatology clinic. Subsequent to the index date, the respective figures were 815 (29.6%) and 1,641 (59.5%). In addition, 133 (4.8%) patients had a post-index inpatient admission with a primary diagnosis of axSpA and 895 (32.5%) had an inpatient admission with a secondary diagnosis. TNFis were prescribed for 97 (3.5%) patients, corticosteroids for 727 (26.4%), NSAIDs for 1,885 (68.4%) and csDMARDs for 461 (16.7%) patients. The most common first-line therapy was NSAIDs (1,579 [57.3%]) (Table). Conclusion This study describes the symptoms of and treatment pathways for axSpA patients within the UK. Issues regarding missing data within routine data should be considered when interpreting the results. Disclosures C.L.I. Morgan: Other; Employee of: Pharmatelligence. A. White: Shareholder/stock ownership; Novartis. Other; Employee of: Novartis. M. Tomlinson: Consultancies; Novartis. A. Scott: Consultancies; Novartis. H. Tian: Other; Employee of: Novartis.