Referrals from primary care physicians to rheumatologists are delayed due to several factors
EXTON, Pa., November 10, 2022 /PRNewswire/ — Rheumatologists in EU5 (France, Germany, Italy, Spainand the UK) recognize a disconnect in the diagnostic and referral process for patients with ankylosing spondylitis (AS) and non-radiographic axial spondylitis (nr-axSpA). The lack of education, awareness of symptoms, and tools needed to properly diagnose these patients has delayed referrals from primary care physicians to rheumatologists.
Spherix Global Insights (“Spherix”) has conducted its first EU5 study of the AS and ax-nr SpA treatment landscape through their Real-Time Dynamix™ serve in July 2022who provided information on patient management and market trends to rheumatologists in the EU5 region.
Rheumatologists rely on a number of tests and imaging to diagnose patients with suspected axSpA (axial spondyloarthritis) in their care, including the use of X-rays and MRIs. However, when analyzing the imaging tests that were done before their axSpA patients were referred to them, the study results show that only half of the suspected patients underwent an X-ray, and fewer got a MRI.
Given the importance of these tests for diagnosis, it is not surprising that treating physicians are often unable to identify the correct condition of these patients before consulting a rheumatologist. In fact, only a quarter of patients with AS were referred with the correct diagnosis, which fell to a tenth among those with nr-axSpA. Most patients referred were either suspected of having the disease or misdiagnosed, the latter being more common in nr-axSpA patients.
Most rheumatologists in the Spherix study agree that primary care physicians are unaware of the symptoms associated with spondyloarthritis, which could explain why X-ray and MRI tests are often not done. Another key issue raised by rheumatologists surveyed is that only a fraction of patients with AS and nr-axSpA are referred to them, noting that some primary care physicians attempt to treat these patients with axSpA.
As indicated in a recent post According to RheumNow on EULAR’s recently updated guidelines for the management of axSpA, early diagnosis of these patients is encouraged to slow disease progression. However, it has been recommended to reconsider the diagnoses and comorbidities of patients who do not respond to treatment. Given the prevalence of misdiagnosis in patients with spondyloarthritis, it is important to get an accurate diagnosis and develop a treatment plan to prevent further joint damage as soon as possible.
The typical treatment approach for a patient with mild AS and nr-axSpA is to use NSAIDs, with patients remaining on these agents for about eight to nine months before switching or adding more advanced therapy. Once the patient has reached moderate disease severity, rheumatologists will introduce biologic agents and JAK inhibitors into the patient’s treatment, depending on the Real-Time Dynamix™ report.
In accordance with EULAR guidelines update, TNF inhibitors are generally the first biologic AS and nr-axSpA patients to be initiated in both indications. Half will transfer to another second-line TNF agent, while IL-17 inhibitors are the main alternative mode of action in the second-line setting or later. JAK inhibitors represent a small part of the third-line or higher share in all indications.
The need for further education on the symptoms associated with AS and nr-axSpA, as well as the tests required for an accurate diagnosis, is paramount to the proper management and treatment of these conditions.
About RealTime Dynamix™
Real-Time Dynamix™ is an independent service providing strategic advice through quarterly or semi-annual reports, which include market trends and a new infusion of event-driven and variable content with each wave. The reports provide an unbiased view of the competitive landscape within rapidly changing specialist markets, powered by robust HCP primary research and our in-house team of experts.
About Spherix Global Insights
Spherix Global Insights is a hyper-focused market intelligence company that leverages our own independent data and expertise to provide strategic advice, so biopharma stakeholders make decisions with confidence. We specialize in certain dermatology, gastroenterology, nephrology, neurology, ophthalmology and rheumatology markets.
All company, brand or product names mentioned in this document are trademarks of their respective holders.
Contact Spherix Global Insights:
Emilie Hettelassociate director of knowledge
Telephone: +1 (484) 879-4284 x7020
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SOURCE Spherix Global Insights