Adherence to Biologics and Psycho-cognitive Factors in Axial Spondyloarthritis: A Multicentric Cross-sectional Study
Maxime Vandersmissen, Charlotte Amory, Jessika Bernard, Jerome Despres, Thomas Barnetche, Justine Landrin, Marie-Elise Truchetet, Cédric Lukas, Cécile Gaujoux Viala, Adeline Ruyssen-Witrand, Anne Tournadre, Pascale Vergne-SalleBackground/Objective:
Adherence to treatment in axial spondyloarthritis (axSpA) remains poorly documented, with estimates ranging from 28.2% to 70.6%. Psychological factors may influence adherence. This study aimed to assess adherence to biological disease-modifying antirheumatic drugs (bDMARDs) and evaluate the impact of catastrophizing, fibromyalgia, anxiety, and depression on adherence.
Methods:
We conducted a 1-year multicenter cross-sectional study, including consecutive axSpA patients fulfilling ASAS criteria. Participants completed a self-administered questionnaire covering demographic data, disease characteristics, and activity scores. Adherence was assessed using the Girerd scale (GS); psychological assessments included the Pain Catastrophizing Scale (PCS), Fibromyalgia Rapid Screening Tool (FIRST), and Hospital Anxiety and Depression Scale (HADS).
Results:
Among 500 patients, 49.2% showed good adherence (GS=0). Prevalence of catastrophizing, fibromyalgia, anxiety, and depression was 17.2%, 21.4%, 25.6%, and 11.0%, respectively. Good adherence was significantly associated with older age (mean 53.3 vs. 45.9 y;
Conclusions:
About half of axSpA patients had suboptimal adherence to bDMARDs. Younger age, anxiety, and catastrophizing were associated with poor adherence and should be considered in patient management.