OBJECTIVES: In patients with axial spondyloarthritis (axSpA) initiating their first tumor necrosis factor alpha-inhibitor (TNFi), we aimed to identify common baseline predictors of Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP) inactive disease (primary objective) and clinically important improvement (CII) at 6 months, and drug retention at 12-months across 15 European registries. METHODS: Baseline demographic and clinical characteristics were collected. Outcomes were investigated per registry and in pooled data using logistic regression analyses on multiply imputed data. RESULTS: The consistency of baseline predictors in individual registries justified pooling the data. In the pooled dataset (n = 21,196), the 6-month rates for ASDAS inactive disease and ASDAS CII were 26% and 51%, and the 12-month drug retention rate 65% in patients with available data (n = 9,845, n = 6,948 and n = 21,196, respectively). Nine common baseline predictors of ASDAS inactive disease, ASDAS CII and 12-month drug retention were identified, and the odds ratios (95%-confidence interval) for ASDAS inactive disease were: age, per year: 0.97 (0.97-0.98), men vs. women: 1.88 (1.60-2.22), current vs. non-smoking: 0.76 (0.63-0.91), HLA-B27 positive vs. negative: 1.51 (1.20-1.91), TNF start year 2015-2018 vs. 2009-2014: 1.24 (1.06-1.45), CRP>10 vs. ≤10 mg/l: 1.49 (1.25-1.77), one unit increase in health assessment questionnaire (HAQ): 0.77 (0.58-1.03), one-millimeter (mm) increase in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) fatigue and spinal pain: 0.99 (0.99-1.00) and 0.99 (0.99-1.99), respectively CONCLUSION: Common baseline predictors of treatment response and adherence to TNFi could be identified across data from 15 European registries, indicating that they may be universal across different axSpA populations.

Aberdeen Centre for Arthritis and Musculoskeletal Health University of Aberdeen Aberdeen UK

Center for Rheumatic Diseases University of Medicine and Pharmacy Romanian Registry of Rheumatic Diseases Bucharest Romania

Center for Rheumatology and Clinical Immunology Division of Medicine Turku University Hospital Turku Finland; Department of Internal Medicine Department of Clinical Medicine University of Turku Turku Finland

Centre for Rheumatology Research Landspitali University Hospital Reykjavik Iceland; Faculty of Medicine University of Iceland Reykjavik Iceland

Clinical Epidemiology Division Department of Medicine Solna Karolinska Institutet Stockholm Sweden

Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Rigshospitalet Glostrup Denmark

Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Rigshospitalet Glostrup Denmark; DANBIO registry Rigshospitalet Glostrup Denmark

Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Rigshospitalet Glostrup Denmark; DANBIO registry Rigshospitalet Glostrup Denmark; Department of Clinical Medicine University of Copenhagen Copenhagen Denmark

Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Rigshospitalet Glostrup Denmark; Department of Clinical Medicine University of Copenhagen Copenhagen Denmark

Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Rigshospitalet Glostrup Denmark; Division of Rheumatology and Research Diakonhjemmet Hospital Oslo Norway; Division of Rheumatology Department of Medicine Hospital of Southern Norway Trust Kristiansand Norway

Department of Clinical Sciences Lund Rheumatology Skåne University Hospital Lund University Lund Sweden

Department of Medicine Solna Karolinska Institutet Stockholm Sweden

Department of Rheumatology Aarhus University Hospital Aarhus Denmark; Department of Clinical Medicine Aarhus University Aarhus Denmark

Department of Rheumatology and Inflammation Research Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden

Department of Rheumatology East Tallinn Central Hospital Tallinn Estonia

Department of Rheumatology Geneva University Hospital Geneva Switzerland

Department of Rheumatology Inflammation Center Helsinki University Hospital and University of Helsinki Helsinki Finland

Department of Rheumatology Radboud UMC Nijmegen the Netherlands

Department of Rheumatology University Hospital Reykjavik Iceland

Department of Rheumatology University Hospital Zurich University of Zurich Zurich Switzerland

Department of Rheumatology University Medical Centre Ljubljana Ljubljana Slovenia; Faculty of Medicine University of Ljubljana Ljubljana Slovenia

Division of Rheumatology and Research Diakonhjemmet Hospital Oslo Norway

Division of Rheumatology Department of Medicine Celal Bayar University Hospital Manisa Turkey

Institute of Rheumatology Prague Czech Republic; Department of Rheumatology 1st Faculty of Medicine Charles University Prague Czech Republic

Reuma pt Sociedade Portuguesa de Reumatologia Lisbon Portugal; Instituto Português de Reumatologia Lisbon Portugal; EpiDoc Unit Nova Medical School Lisbon Portugal

Rheumatology Unit Department of Medical and Surgical Sciences University of Foggia Italy

Rheumatology Unit DETO University of Bari Bari Italy

Serviço de Reumatologia Hospital Garcia de Orta Almada Portugal; Reuma pt Sociedade Portuguesa de Reumatologia Lisbon Portugal

Semin Arthritis Rheum. 2023 Feb;58:152141. doi: 10.1016/j.semarthrit.2022.152141. PubMed

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