Determinants associated with the prescription of a first biologic therapy in patients with axial spondyloarthritis and concomitant fibromyalgia in daily practice

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine Pub Date : 2024-09-11 DOI:10.1016/j.jbspin.2024.105773

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引用次数: 0

Abstract

Objectives

There is no consensus on the therapeutic strategy of rheumatologists for patients with spondyloarthritis (SpA) and concomitant fibromyalgia (FM). The main aim of this study was to identify, in a population of rheumatologists practicing in Normandy, France, the determinants associated with their decision to prescribe a first biologic DMARD (bDMARD) in patients with Spa/FM. Specific objectives were to evaluate professional prescribing practices to identify a set of criteria likely to contribute to the therapeutic decision of rheumatologists, and to validate the relevance of these criteria.

Method

This is a cross-sectional survey-based study using a mixed (qualitative and quantitative) method. The quantitative approach was web-based and conducted among rheumatologists in Normandy.

Results

The qualitative study allowed us to identify a set of criteria likely to contribute to the therapeutic decision of rheumatologists. In the quantitative study, 54/113 rheumatologists filled the questionnaire. Four criteria were considered by all respondents to contribute to their decision to prescribe a first bDMARD: arthritis on physical examination, extra-articular manifestations, systemic inflammation and structural damage on imaging.

Conclusions

The determinants associated with the decision of rheumatologists to prescribe a first bDMARD in patients with SpA/FM were mostly objective, in line with the recommendations in the literature. Most criteria were more related to an approach aimed at ensuring the diagnosis of SpA than evaluating its activity or severity.

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对患有轴性脊柱关节炎并同时伴有纤维肌痛的患者开具第一种生物疗法处方的相关决定因素大多是客观的，且符合建议。采用混合（定性和定量）方法进行的横断面调查研究结果，有助于风湿免疫科医生的日常工作。

目的：本研究的主要目的是在法国诺曼底地区执业的风湿病学家群体中，确定与他们决定为脊柱关节炎（Spa）/纤维肌痛（FM）患者开具第一种生物DMARD（bDMARD）处方相关的决定因素。具体目标是评估专业处方实践，以确定一套可能有助于风湿病学家做出治疗决定的标准，并验证这些标准的相关性：这是一项以横断面调查为基础的研究，采用了混合（定性和定量）方法。定量方法以网络为基础，在诺曼底地区的风湿病专家中进行：定性研究使我们确定了一套可能有助于风湿病专家做出治疗决定的标准。在定量研究中，54/113 名风湿病学家填写了调查问卷。所有受访者都认为有四项标准有助于他们决定是否首次开具 bDMARD：体格检查中的关节炎、关节外表现、全身炎症和影像学上的结构性损害：与风湿免疫科医生决定为 SpA/FM 患者开具首个 bDMARD 处方相关的决定因素大多是客观的，与文献中的建议一致。大多数标准更多地与旨在确保SpA诊断的方法有关，而不是评估其活动性或严重性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Joint Bone Spine 医学-风湿病学

CiteScore

4.50

自引率

11.90%

发文量

184

审稿时长

25 days

期刊介绍： Bimonthly e-only international journal, Joint Bone Spine publishes in English original research articles and all the latest advances that deal with disorders affecting the joints, bones, and spine and, more generally, the entire field of rheumatology. All submitted manuscripts to the journal are subjected to rigorous peer review by international experts: under no circumstances does the journal guarantee publication before the editorial board makes its final decision. (Surgical techniques and work focusing specifically on orthopedic surgery are not within the scope of the journal.)Joint Bone Spine is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.