{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T20:10:04Z","timestamp":1754079004273,"version":"3.41.2"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Although axial spondyloarthritis (axSpA) typically begins before age 45, late-onset axSpA (lo-axSpA) has been widely recognized. While existing literature describes this subgroup, data on therapeutic approaches remain limited. Therefore, we aimed to evaluate the efficacy and safety of biologic DMARDs in patients with lo-axSpA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective, multicentre, national cohort study using data from the Rheumatic Diseases Portuguese Register. A cut-off age of 45\u2009years was applied to define lo-axSpA. Group differences between early- and late-onset disease activity scores were evaluated, and drug survival was assessed over 12\u2009months. Predictors of drug discontinuation were identified using a Cox proportional hazards model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 2256 patients were included, of whom 260 (11.5%) had lo-axSpA. Patients with late-onset disease exhibited significantly higher scores in the Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index at baseline, 3, 6 and 12\u2009months. Despite these differences, both groups showed proportional reductions in disease activity scores, indicating a continuous decrease in disease activity over time. Although the late-onset group had a higher discontinuation rate during the first 12\u2009months of treatment, lo-axSpA was not associated with an increased risk of therapy discontinuation. The primary reason for treatment discontinuation in both groups was inefficacy, with low rates of infections and other adverse events observed across the cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our study demonstrated that lo-axSpA is not associated with reduced treatment efficacy or compromised safety.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/rheumatology\/keaf176","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T17:17:49Z","timestamp":1743441469000},"page":"4565-4573","source":"Crossref","is-referenced-by-count":0,"title":["Biologic disease-modifying antirheumatic drugs survival in late-onset axial spondyloarthritis \u2014 data from a Portuguese registry"],"prefix":"10.1093","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4797-047X","authenticated-orcid":false,"given":"Susana P","family":"Silva","sequence":"first","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade Regi\u00e3o de Aveiro , Aveiro,","place":["Portugal"]},{"name":"Centro Acad\u00e9mico Cl\u00ednico Egas Moniz Health Alliance , Aveiro,","place":["Portugal"]}]},{"given":"Beatriz","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Department of Mathematics and CIDMA, Center for Research & Development in Mathematics and Applications, University of Aveiro , Aveiro,","place":["Portugal"]}]},{"given":"Cl\u00e1udia","family":"Pinto Oliveira","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade Regi\u00e3o de Aveiro , Aveiro,","place":["Portugal"]},{"name":"Centro Acad\u00e9mico Cl\u00ednico Egas Moniz Health Alliance , Aveiro,","place":["Portugal"]}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4384-8660","authenticated-orcid":false,"given":"Roberto","family":"Pereira da Costa","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade de Santa Maria, Centro Acad\u00e9mico de Medicina de Lisboa , Lisboa,","place":["Portugal"]},{"name":"Faculdade de Medicina, Universidade de Lisboa, Centro Acad\u00e9mico de Medicina de Lisboa , Lisboa,","place":["Portugal"]}]},{"given":"Carolina Och\u00f4a","family":"Matos","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade de Santa Maria, Centro Acad\u00e9mico de Medicina de Lisboa , Lisboa,","place":["Portugal"]},{"name":"Faculdade de Medicina, Universidade de Lisboa, Centro Acad\u00e9mico de Medicina de Lisboa , Lisboa,","place":["Portugal"]}]},{"given":"Mariana Diz","family":"Lopes","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o , Porto,","place":["Portugal"]},{"name":"Department of Medicine, Faculty of Medicine, University of Porto , Porto,","place":["Portugal"]}]},{"given":"Carlos Marques","family":"Gomes","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o , Porto,","place":["Portugal"]},{"name":"Department of Medicine, Faculty of Medicine, University of Porto , Porto,","place":["Portugal"]}]},{"given":"Miguel","family":"Bernardes","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o , Porto,","place":["Portugal"]},{"name":"Department of Medicine, Faculty of Medicine, University of Porto , Porto,","place":["Portugal"]}]},{"given":"Mariana Em\u00edlia","family":"Santos","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade de Lisboa Ocidental , Lisboa,","place":["Portugal"]},{"name":"Nova Medical School, Universidade Nova de Lisboa , Lisboa,","place":["Portugal"]}]},{"given":"Laura","family":"Gago","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade de Lisboa Ocidental , Lisboa,","place":["Portugal"]},{"name":"Nova Medical School, Universidade Nova de Lisboa , Lisboa,","place":["Portugal"]}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5141-7954","authenticated-orcid":false,"given":"Catarina","family":"Abreu","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade de Almada-Seixal , Almada,","place":["Portugal"]}]},{"given":"Vanessa","family":"Fraga","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade de Almada-Seixal , Almada,","place":["Portugal"]}]},{"given":"Beatriz","family":"Mendes","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade de Coimbra , Coimbra,","place":["Portugal"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3665-8210","authenticated-orcid":false,"given":"Margarida","family":"Lucas Rocha","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade do Algarve , Faro,","place":["Portugal"]}]},{"given":"Catarina Dantas","family":"Soares","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade do Alto Minho , Ponte de Lima,","place":["Portugal"]}]},{"given":"C\u00e2ndida","family":"Silva","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Instituto Portugu\u00eas de Reumatologia , Lisboa,","place":["Portugal"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1396-8988","authenticated-orcid":false,"given":"Helena","family":"Santos","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Instituto Portugu\u00eas de Reumatologia , Lisboa,","place":["Portugal"]}]},{"given":"Paula","family":"Valente","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade de Entre o Douro e Vouga , Santa Maria da Feira,","place":["Portugal"]}]},{"given":"L\u00edgia","family":"Silva","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade de Tr\u00e1s-os-Montes e Alto Douro , Vila Real,","place":["Portugal"]}]},{"given":"Gisela","family":"Eug\u00e9nio","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade Regi\u00e3o de Aveiro , Aveiro,","place":["Portugal"]},{"name":"Centro Acad\u00e9mico Cl\u00ednico Egas Moniz Health Alliance , Aveiro,","place":["Portugal"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4116-8964","authenticated-orcid":false,"given":"Anabela","family":"Barcelos","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Unidade Local de Sa\u00fade Regi\u00e3o de Aveiro , Aveiro,","place":["Portugal"]},{"name":"Centro Acad\u00e9mico Cl\u00ednico Egas Moniz Health Alliance , Aveiro,","place":["Portugal"]},{"name":"EpiDoC Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa , Lisboa,","place":["Portugal"]},{"name":"NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, Universidade NOVA de Lisboa , Lisboa,","place":["Portugal"]}]}],"member":"286","published-online":{"date-parts":[[2025,4,1]]},"reference":[{"key":"2025080115374655600_keaf176-B1","doi-asserted-by":"crossref","first-page":"e001955","DOI":"10.1136\/rmdopen-2021-001955","article-title":"Measuring quality of life of patients with axial spondyloarthritis for economic evaluation","volume":"8","author":"Hernandez Alava","year":"2022","journal-title":"RMD Open"},{"key":"2025080115374655600_keaf176-B2","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/S0140-6736(16)31591-4","article-title":"Axial 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