The Sequence of Disease Modifying Anti-Rheumatic Drugs: Pathways to and Predictors of Tocilizumab Monotherapy

The sequence of disease-modifying anti-rheumatic drugs: pathways to and predictors of tocilizumab monotherapy

Arthritis Research & Therapy ◽

10.1186/s13075-020-02408-4 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Daniel H. Solomon ◽

Chang Xu ◽

Jamie Collins ◽

Seoyoung C. Kim ◽

Elena Losina ◽

...

Keyword(s):

Real World ◽

Large Scale ◽

Disease Duration ◽

Learning Algorithm ◽

Supervised Machine Learning ◽

Tnf Inhibitor ◽

Discrete State ◽

Prior Use ◽

Disease Modifying ◽

Tocilizumab Monotherapy

Abstract Background There are numerous non-biologic and biologic disease-modifying anti-rheumatic drugs (bDMARDs) for rheumatoid arthritis (RA). Typical sequences of bDMARDs are not clear. Future treatment policies and trials should be informed by quantitative estimates of current treatment practice. Methods We used data from Corrona, a large real-world RA registry, to develop a method for quantifying sequential patterns in treatment with bDMARDs. As a proof of concept, we study patients who eventually use tocilizumab monotherapy (TCZm), an IL-6 antagonist with similar benefits used as monotherapy or in combination. Patients starting a bDMARD were included and were followed using a discrete-state Markov model, observing changes in treatments every 6 months and determining whether they used TCZm. A supervised machine learning algorithm was then employed to determine longitudinal patient factors associated with TCZm use. Results 7300 patients starting a bDMARD were followed for up to 5 years. Their median age was 58 years, 78% were female, median disease duration was 5 years, and 57% were seropositive. During follow-up, 287 (3.9%) reported use of TCZm with median time until use of 25.6 (11.5, 56.0) months. Eighty-two percent of TCZm use began within 3 years of starting any bDMARD. Ninety-three percent of TCZm users switched from TCZ combination, a TNF inhibitor, or another bDMARD. Very few patients are given TCZm as their first DMARD (0.6%). Variables associated with the use of TCZm included prior use of TCZ combination therapy, older age, longer disease duration, seronegative, higher disease activity, and no prior use of a TNF inhibitor. Conclusions Improved understanding of treatment sequences in RA may help personalize care. These methods may help optimize treatment decisions using large-scale real-world data.

The Sequence of Disease Modifying Anti-Rheumatic Drugs: Pathways to and Predictors of Tocilizumab Monotherapy

10.21203/rs.3.rs-57396/v3 ◽

2021 ◽

Author(s):

Daniel Solomon ◽

Chang Xu ◽

Jamie Collins ◽

Seoyoung C. Kim ◽

Elena Losina ◽

...

Keyword(s):

Real World ◽

Large Scale ◽

Disease Duration ◽

Learning Algorithm ◽

Supervised Machine Learning ◽

Tnf Inhibitor ◽

Discrete State ◽

Prior Use ◽

Disease Modifying ◽

Tocilizumab Monotherapy

Abstract Background: There are numerous non-biologic and biologic disease modifying anti-rheumatic drugs (bDMARDs) for rheumatoid arthritis (RA). Typical sequences of bDMARDs are not clear. Future treatment policies and trials should be informed by quantitative estimates of current treatment practice. Methods: We used data from Corrona, a large real-world RA registry, to develop a method for quantifying sequential patterns in treatment with bDMARDs. As a proof of concept, we study patients who eventually use tocilizumab monotherapy (TCZm), an IL-6 antagonist with similar benefits used as monotherapy or in combination. Patients starting a bDMARD were included and were followed using a discrete-state Markov model, observing changes in treatments every six-months and determining whether they used TCZm. A supervised machine learning algorithm was then employed to determine longitudinal patient factors associated with TCZm use.Results: 7,300 patients starting a bDMARD were followed for up to 5 years. Their median age was 58 years, 78% were female, median disease duration was 5 years, and 57% were seropositive. During follow-up, 287 (3.9%) reported use of TCZm with median time until use of 25.6 (11.5, 56.0) months. 82% of TCZm use began within three years of starting any bDMARD. 93% of TCZm users switched from TCZ combination, a TNF inhibitor, or another bDMARD. Very few patients are given TCZm as their first DMARD (0.6%). Variables associated with use of TCZm included: prior use of TCZ combination therapy, older age, longer disease duration, seronegative, higher disease activity, and no prior use of a TNF inhibitor.Conclusions: Improved understanding of treatment sequences in RA may help personalize care. These methods may help optimize treatment decisions using large-scale real-world data.

The Sequence of Disease Modifying Anti-Rheumatic Drugs: Pathways to and Predictors of Tocilizumab Monotherapy

10.21203/rs.3.rs-57396/v2 ◽

2020 ◽

Author(s):

Daniel Solomon ◽

Chang Xu ◽

Jamie Collins ◽

Seoyoung C. Kim ◽

Elena Losina ◽

...

Keyword(s):

Real World ◽

Large Scale ◽

Disease Duration ◽

Learning Algorithm ◽

Supervised Machine Learning ◽

Tnf Inhibitor ◽

Discrete State ◽

Prior Use ◽

Disease Modifying ◽

Tocilizumab Monotherapy

Abstract Background: There are numerous non-biologic and biologic disease modifying anti-rheumatic drugs (bDMARDs) for rheumatoid arthritis (RA). Typical sequences of bDMARDs are not clear. Future treatment policies and trials should be informed by quantitative estimates of current treatment practice. Methods: We used data from Corrona, a large real-world RA registry, to develop a method for quantifying sequential patterns in treatment with bDMARDs. As a proof of concept, we study patients who eventually use tocilizumab monotherapy (TCZm), an IL-6 antagonist with similar benefits used as monotherapy or in combination. Patients starting a bDMARD were included and were followed using a discrete-state Markov model, observing changes in treatments every six-months and determining whether they used TCZm. A supervised machine learning algorithm was then employed to determine longitudinal patient factors associated with TCZm use. Results: 7,300 patients starting a bDMARD were followed for up to 5 years. Their median age was 58 years, 78% were female, median disease duration was 5 years, and 57% were seropositive. During follow-up, 287 (3.9%) reported use of TCZm with median time until use of 25.6 (11.5, 56.0) months. 82% of TCZm use began within three years of starting any bDMARD. 93% of TCZm users switched from TCZ combination, a TNF inhibitor, or another bDMARD. Very few patients are given TCZm as their first DMARD (0.6%). Variables associated with use of TCZm included: prior use of TCZ combination therapy, older age, longer disease duration, seronegative, higher disease activity, and no prior use of a TNF inhibitor. Conclusions: Improved understanding of treatment sequences in RA may help personalize care. These methods may help optimize treatment decisions using large-scale real-world data.

Prädiktoren für Progression und Mortalität bei Patienten mit RA-assoziierter ILD

Karger Kompass Pneumologie ◽

10.1159/000518288 ◽

2021 ◽

pp. 1-3

Author(s):

Nicolas Carlos Kahn

Keyword(s):

Carbon Monoxide ◽

Lung Function ◽

Lung Disease ◽

Pulmonary Function Tests ◽

Diffusing Capacity ◽

Radiological Progression ◽

Cox Regression Analysis ◽

Factors Associated ◽

Disease Modifying

Objectives: To describe a prospective cohort of patients with rheumatoid arthritis associated with interstitial lung disease (RA-ILD) and identify risk factors associated with disease progression and mortality in this cohort. Patients and methods: We performed a multicenter, prospective, observational study of patients with RA-ILD receiving disease-modifying antirheumatic drugs (DMARDs) between 2015 and 2020. The patients were assessed using high-resolution computed tomography and pulmonary function tests at baseline and at 60 months. The main endpoint was «Progression to ILD at the end of follow-up» in terms of the following outcomes: (1) improvement (i.e., improvement in forced vital capacity (FVC) ≥10% or diffusing capacity of the lungs for carbon monoxide (DLCO) ≥15% and absence of radiological progression); (2) nonprogression (stabilization or improvement in FVC ≤10% or diffusing capacity of the lungs for carbon monoxide (DLCO) <15% and absence of radiological progression); (3) progression (worsening of FVC >10% or DLCO >15% and radiological progression); or (4) death. We recorded demographic and clinical characteristics, lung function, and the incidence of adverse events. A Cox regression analysis was performed to identify factors associated with the worsening of ILD. Results: After 60 months, lung disease had stabilized in 66 patients (56.9%), improved in 9 (7.8%), and worsened in 23 (19.8%). Eighteen patients (15.5%) died, with a mean survival of 71.8 (1.9) months after diagnosis of ILD. The Cox multivariate analysis revealed the independent predictors of worsening of RA-ILD to be usual interstitial pneumonia (hazard ratio (HR), 2.6 (95%CI, 1.0–6.7)), FVC <80% (HR, 3.8 (95%CI, 1.5–6.7)), anticitrullinated protein antibody titers (HR, 2.8 (95%CI, 1.1–6.8)), smoking (HR, 2.5 (95%CI, 1.1–6.2)), and treatment with abatacept, tocilizumab, or rituximab (HR, 0.4 (95%CI, 0.2–0.8)). During follow-up, 79 patients (68%) experienced an adverse event, mostly infection (61%). Infection was fatal in 10/18 patients (55.5%) during follow-up. Conclusions: Lung function is stable in most patients with RA-ILD receiving treatment with disease-modifying anti-rheumatic drugs (DMARDs), although one-third worsened or died. Identifying factors associated with worsening in RA-ILD is important for clinical management.

Real-life experience with 4 years of golimumab persistence in ulcerative colitis patients

Scientific Reports ◽

10.1038/s41598-020-73577-0 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Marisa Iborra ◽

Natalia García-Morales ◽

Saoia Rubio ◽

Federico Bertoletti ◽

Marta Calvo ◽

...

Keyword(s):

Ulcerative Colitis ◽

Disease Duration ◽

Life Experience ◽

Real Life ◽

Efficacy And Safety ◽

Dose Intensification ◽

Factors Associated ◽

Mean Time

Abstract Golimumab has demonstrated its long-term efficacy and safety in ulcerative colitis in clinical trials, but no data of long-term persistence has been published from real world. To estimate long-term persistence of golimumab, as well as factors associated with longer persistence, in patients with ulcerative colitis in real life. Observational multicentre study including adult patients with ulcerative colitis treated with golimumab and with at least twelve months of follow-up. We included 190 patients, 105 (55.26%) naive to anti-TNF, with mean disease duration of 9.32 ± 8.09 years. Probability of persistence was 63%, 46%, 39% and 27% at 1, 2, 3 and 4 years, respectively. Persistence was lower in patients with primary failure to previous anti-TNF. Eighty-two (43.16%) patients needed dose intensification during follow-up, with a mean time until intensification of 8.03 ± 8.64 months. Dose intensification and lower disease duration predicted higher persistence with golimumab (p = 0.037 and p = 0.008, respectively). During a follow-up of 17.25 ± 15.83 months, 32 (16.5%) patients needed hospitalisation and 11 (6%) underwent colectomy. No unexpected adverse events were reported. Golimumab has demonstrated good persistence and safety profile for long treatment in ulcerative colitis patients.

OP0299 IN RHEUMATOID ARTHRITIS PATIENTS HIGHER NUMBER OF COMORBIDITIES PREDICTS 6-MONTH INSUFFICIENT RESPONSE TO FIRST BIOLOGIC THERAPY AND EVENTUAL CATEGORIZATION OF THE DISEASE AS DIFFICULT-TO-TREAT

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4110 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 184.2-184

Author(s):

I. Flouri ◽

A. Repa ◽

N. Avgustidis ◽

N. Kougkas ◽

A. Eskitzis ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Disease Duration ◽

Response To Therapy ◽

Disease Classification ◽

University Hospital ◽

Tnf Inhibitor ◽

Definition Of ◽

The Impact

Background:Difficult-to-treat rheumatoid arthritis (D2T RA) was recently defined by a EULAR study group (1) and, as a disease category it is largely complicated and under-researched. Patient comorbidities may play a significant role in the response to therapy with biologic disease-modifying antirheumatic drugs (bDMARDs) and in the disease classification as D2T RA.Objectives:To evaluate the impact of comorbidities [studied as total Comorbidities Count (CC) and rheumatic disease comorbidity index (RDCI)] on 6-month response to therapy with the first bDMARD in real-world clinical practice and on eventual disease designation as D2T RA.Methods:Prospective study of all RA patients who start any bDMARD in a tertiary centre University Hospital after their consent. All patient comorbidities [among a list of approximately 100 pre-specified major comorbidities] are registered by treating physicians. Response to therapy was defined as achievement of low disease activity or remission (LDA/Rem) according to simplified disease activity index (SDAI) and health assessment questionnaire (HAQ) improvement of ≥ 0.25.D2T RA patient group was defined according to the EULAR definition of D2T RA and was compared to: a/ all other patients and b/ to a sub-group of patients designated as “well-controlled RA” (follow-up ≥2 years and ≥2 visits in the last year in LDA/Rem).Logistic regression models were used to adjust for the potential confounding of age, sex, disease duration, seropositivity, number of previous synthetic DMARDs, type of 1st bDMARD initiated (TNF inhibitor vs. non-TNF inhibitor), co-administered methotrexate and corticosteroids (yes/no), baseline SDAI and HAQ and year of therapy start.Results:Analysis included 501 RA patients who received a total of 1098 bDMARD treatments. At 1st bDMARD treatment start, patients (women: 81%) had a median (IQR) age: 60 (51-68) years, disease duration: 5.4 (3-11) years, SDAI: 36 (28-46), HAQ: 1.0 (0.5-1.5), CC: 3 (2-6) και RDCI: 2 (0-3).In adjusted analyses, total comorbidity count (CC) ≤1 (vs ≥ 2) was predicting LDA/Rem at 6 months of therapy [OR (95%CI) = 4.1 (1.5-11), p=0.005], while RDCI=0 (vs. ≥ 1) was predicting HAQ improvement ≥ 0.25 [OR (95% CI) = 2.6 (1.2-6.7), p=0.046].During 2614 patient-years of follow-up, the disease in 98 patients could be classified as “D2T RA”, while 127 patients had “well-controlled RA”. Baseline independent predictors for D2T RA compared to all other patients were RDCI ≥ 1 (vs. 0) [OR = 3.3 (1.7-9.4), p = 0.024], female sex [OR =3.1 (1.01-9.5)] and age [OR = 0.97 (0.94-0.99)]. Multivariable analyses for predictors of “D2T” compared to “well-controlled” RA yielded similar results.Conclusion:In RA patients starting the first bDMARD treatment, a higher number of comorbidities at baseline is an independent predictor of lower 6-month response to therapy and final disease classification as “difficult-to-treat” RA.References:[1]Nagy G, Roodenrijs NM, Welsing PM, Kedves M, Hamar A, van der Goes MC, et al. EULAR definition of difficult-to-treat rheumatoid arthritis. Ann Rheum Dis. 2021 Jan;80(1):31–5.Acknowledgements:Pancretan Health Association and Special Account for Research Grants (ELKE) – University of Crete.Disclosure of Interests:None declared.

Predictors of Progression and Mortality in Patients with Prevalent Rheumatoid Arthritis and Interstitial Lung Disease: A Prospective Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm10040874 ◽

2021 ◽

Vol 10 (4) ◽

pp. 874

Author(s):

Natalia Mena-Vázquez ◽

Marta Rojas-Gimenez ◽

Carmen María Romero-Barco ◽

Sara Manrique-Arija ◽

Espildora Francisco ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Carbon Monoxide ◽

Interstitial Lung Disease ◽

Lung Function ◽

Lung Disease ◽

Diffusing Capacity ◽

Radiological Progression ◽

Factors Associated ◽

Disease Modifying

Objectives: To describe a prospective cohort of patients with rheumatoid arthritis associated with interstitial lung disease (RA-ILD) and identify risk factors associated with disease progression and mortality in this cohort. Patients and methods: We performed a multicenter, prospective, observational study of patients with RA-ILD receiving disease-modifying antirheumatic drugs (DMARDs) between 2015 and 2020. The patients were assessed using high-resolution computed tomography and pulmonary function tests at baseline and at 60 months. The main endpoint was “Progression to ILD at the end of follow-up” in terms of the following outcomes: (1) improvement (i.e., improvement in forced vital capacity (FVC) ≥10% or diffusing capacity of the lungs for carbon monoxide (DLCO) ≥15% and absence of radiological progression); (2) nonprogression (stabilization or improvement in FVC ≤10% or diffusing capacity of the lungs for carbon monoxide (DLCO) <15% and absence of radiological progression); (3) progression (worsening of FVC >10% or DLCO >15% and radiological progression); or (4) death. We recorded demographic and clinical characteristics, lung function, and the incidence of adverse events. A Cox regression analysis was performed to identify factors associated with the worsening of ILD. Results: After 60 months, lung disease had stabilized in 66 patients (56.9%), improved in 9 (7.8%), and worsened in 23 (19.8%). Eighteen patients (15.5%) died, with a mean survival of 71.8 (1.9) months after diagnosis of ILD. The Cox multivariate analysis revealed the independent predictors of worsening of RA-ILD to be usual interstitial pneumonia (hazard ratio (HR), 2.6 (95%CI, 1.0–6.7)), FVC <80% (HR, 3.8 (95%CI, 1.5–6.7)), anticitrullinated protein antibody titers (HR, 2.8 (95%CI, 1.1–6.8)), smoking (HR, 2.5 (95%CI, 1.1–6.2)), and treatment with abatacept, tocilizumab, or rituximab (HR, 0.4 (95%CI, 0.2–0.8)). During follow-up, 79 patients (68%) experienced an adverse event, mostly infection (61%). Infection was fatal in 10/18 patients (55.5%) during follow-up. Conclusions: Lung function is stable in most patients with RA-ILD receiving treatment with disease-modifying anti-rheumatic drugs (DMARDs), although one-third worsened or died. Identifying factors associated with worsening in RA-ILD is important for clinical management.

Prädiktoren für Progression und Mortalität bei Patienten mit RA-assoziierter ILD

Karger Kompass Autoimmun ◽

10.1159/000518343 ◽

2021 ◽

pp. 1-3

Author(s):

Nicolas Carlos Kahn

Keyword(s):

Carbon Monoxide ◽

Lung Function ◽

Lung Disease ◽

Pulmonary Function Tests ◽

Diffusing Capacity ◽

Radiological Progression ◽

Cox Regression Analysis ◽

Factors Associated ◽

Disease Modifying

Objectives: To describe a prospective cohort of patients with rheumatoid arthritis associated with interstitial lung disease (RA-ILD) and identify risk factors associated with disease progression and mortality in this cohort. Patients and methods: We performed a multicenter, prospective, observational study of patients with RA-ILD receiving disease-modifying antirheumatic drugs (DMARDs) between 2015 and 2020. The patients were assessed using high-resolution computed tomography and pulmonary function tests at baseline and at 60 months. The main endpoint was «Progression to ILD at the end of follow-up» in terms of the following outcomes: (1) improvement (i.e., improvement in forced vital capacity (FVC) ≥10% or diffusing capacity of the lungs for carbon monoxide (DLCO) ≥15% and absence of radiological progression); (2) nonprogression (stabilization or improvement in FVC ≤10% or diffusing capacity of the lungs for carbon monoxide (DLCO) <15% and absence of radiological progression); (3) progression (worsening of FVC >10% or DLCO >15% and radiological progression); or (4) death. We recorded demographic and clinical characteristics, lung function, and the incidence of adverse events. A Cox regression analysis was performed to identify factors associated with the worsening of ILD. Results: After 60 months, lung disease had stabilized in 66 patients (56.9%), improved in 9 (7.8%), and worsened in 23 (19.8%). Eighteen patients (15.5%) died, with a mean survival of 71.8 (1.9) months after diagnosis of ILD. The Cox multivariate analysis revealed the independent predictors of worsening of RA-ILD to be usual interstitial pneumonia (hazard ratio (HR), 2.6 (95%CI, 1.0–6.7)), FVC <80% (HR, 3.8 (95%CI, 1.5–6.7)), anticitrullinated protein antibody titers (HR, 2.8 (95%CI, 1.1–6.8)), smoking (HR, 2.5 (95%CI, 1.1–6.2)), and treatment with abatacept, tocilizumab, or rituximab (HR, 0.4 (95%CI, 0.2–0.8)). During follow-up, 79 patients (68%) experienced an adverse event, mostly infection (61%). Infection was fatal in 10/18 patients (55.5%) during follow-up. Conclusions: Lung function is stable in most patients with RA-ILD receiving treatment with disease-modifying anti-rheumatic drugs (DMARDs), although one-third worsened or died. Identifying factors associated with worsening in RA-ILD is important for clinical management.

Influence of selected demographic and clinical factors on the treatment of rheumatoid arthritis – a long-term follow-up

Pediatria i Medycyna Rodzinna ◽

10.15557/pimr.2021.0023 ◽

2021 ◽

Vol 17 (2) ◽

pp. 142-147

Author(s):

Robert Kruszewski ◽

◽

Bartłomiej Kisiel ◽

Witold Tłustochowicz ◽

Keyword(s):

Rheumatoid Arthritis ◽

Body Mass Index ◽

Disease Activity ◽

Body Mass ◽

Disease Duration ◽

Biological Therapy ◽

Disease Onset ◽

Onset Age ◽

Disease Modifying

Robert Kruszewski, Bartłomiej Kisiel, Witold TłustochowiczMethotrexate is recommended as a first-line drug in the treatment of rheumatoid arthritis, however, clinical practice often requires a change in the therapeutic approach. Our objective was to evaluate the influence of several demographic and diseaserelated factors on the treatment of rheumatoid arthritis. A group of 143 rheumatoid arthritis patients, initially treated with methotrexate in monotherapy or in combination with glucocorticoids, was followed for an average of 7.5 years. A search for associations between age, sex, disease onset age, disease duration, body mass index, smoking, rheumatoid factor and anticitrullinated protein antibodies status, initial disease activity, bone erosions and rheumatoid arthritis treatment during the follow-up was performed. Patients receiving biological therapy were younger than those on other types of treatment (50.57 ± 13.39 vs. 58.86 ± 11.67 years; p = 0.0013), had slightly lower disease onset age (41.78±13.03 vs. 47.88 ± 13.74 years; p = 0.035) and more prevalent high levels of anti-citrullinated protein antibodies (91% vs. 66%; p = 0.02). On the other hand, patients on methotrexate monotherapy were older than those receiving other therapies (61.51 ± 10.86 vs. 53.97±12.61 years; p = 0.0002) and had slightly higher disease onset age (52.08 ± 13.20 vs. 42.55 ± 12.82 years; p = 0.000026). Higher initial disease activity (DAS28) was associated with a need for prolonged treatment with biological agents or biological therapy with addition of synthetic disease modifying antirheumatic drugs other than methotrexate. We found no relationships between sex, disease duration, body mass index, smoking or radiological erosions and the type of received disease modifying antirheumatic drug. Patient’s actual age and disease onset age seem to have the most significant impact on rheumatoid arthritis treatment course.

Prediction of work impact in axial spondylarthritis by the Work instability Scale, a prospective cohort study of 101 patients.

The Journal of Rheumatology ◽

10.3899/jrheum.191397 ◽

2020 ◽

pp. jrheum.191397

Author(s):

Irina Cucos ◽

Sabrina Dadoun ◽

Charlotte Jacquemin ◽

Sarah Kreis ◽

Stephanie Fabre ◽

...

Keyword(s):

Cohort Study ◽

Sick Leave ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Disease Duration ◽

Professional Activity ◽

Tnf Inhibitor ◽

Short Term ◽

Work Impact

Objective Axial spondyloarthritis (axSpA) may have an impact on work. The Ankylosing Spondylitis Work Instability Scale (AS-WIS) assesses difficulties at work. The objective of this study was to evaluate the predictive value of the AS WIS on work impact. Methods Prospective cohort study with two timepoints (at baseline and after 1.5 years) including patients with axSpA and a paid professional activity. Patients completed the AS-WIS at baseline and work instability was scored as moderate/high if ≥11 (0-20 scale). At follow up, adverse work outcomes (AWO) were defined as short-term sick leave or severe AWO (long-term sick leave, disability, unemployment). Univariable and multivariable logistic regression analyses were performed to explain AWO. Results Of 101 patients, mean age 45 (standard deviation (SD) 9) years, 52% male, disease duration was 14 (SD 8) years. The BASDAI and the BASFI were respectively 34 (SD 21) and 23 (SD 23), 69 (68%) received a TNF-inhibitor. At baseline, 46 (46%) patients had moderate/high AS-WIS. At 1.5 years of follow-up, 37 patients (36%) had AWO: 25 patients (25%) a short-term sick leave, and 12 patients (12%, 7/100 patient years) a severe AWO. Independent baseline factors associated with AWO were a moderate/high AS-WIS score (odds ratio 2.71 [95% confidence interval 1.04-7.22]) and shorter disease duration (0.94 [0.89-0.99]). Conclusion In patients with axSpA, a moderate/high AS-WIS score was predictive of AWO in this population with well-controlled axSpA. This short questionnaire can be helpful to screen for future difficulties at work.