{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:24:04Z","timestamp":1790663044632,"version":"4.1.0"},"reference-count":36,"publisher":"The Journal of Rheumatology","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore residual disease, defined as substantial symptoms and disease burden despite a remission or low disease activity (LDA) state, in patients with axial spondyloarthritis (axSpA), and to determine which factors are associated with residual disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For this cross-sectional observational study, 1 timepoint per patient was used from SpA-Net, a web-based monitoring registry for SpA. Patients with an Ankylosing Spondylitis Disease Activity Score (ASDAS) &lt; 2.1 (LDA) were included. Indicators of residual disease (outcomes) included fatigue (primary outcome), pain, physical functioning, health-related quality of life (HRQOL), and peripheral symptoms. Sex was the primary explanatory factor for residual disease. Other explanatory factors included demographics and disease-related factors. Associations between these factors and presence and extent of residual disease were explored using logistic and linear regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 267 patients in an LDA state were included. Mean age was 50.6 (SD 14.3) years and 100 (37.5%) were female. Residual disease occurred frequently (n = 114 [42.7%] had fatigue scores &gt; 4\/10; n = 34 [17.8%] had pain scores &gt; 4\/10), including in those in remission (ASDAS &lt; 1.3). Physical HRQOL was reduced in 27% and moderate\/poor in 33%. Multivariable regression analyses showed that reported fatigue was more severe and prevalent in female patients (fatigue severity [0\u201310]: B<jats:sub>female<\/jats:sub>= 0.78, 95% CI 0.18-1.38; fatigue &gt; 4\/10: OR<jats:sub>female<\/jats:sub>= 3.29, 95% CI 1.74-6.20). Other indicators of residual disease (ie, pain, peripheral symptoms, physical HRQOL) were also more severe and\/or more prevalent in females.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Residual disease is frequent in patients with axSpA who are in an LDA state, including remission, and it is particularly prevalent in female patients. Future studies should address how to manage or prevent residual disease in axSpA.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.2023-0194","type":"journal-article","created":{"date-parts":[[2023,7,15]],"date-time":"2023-07-15T12:20:19Z","timestamp":1689423619000},"page":"1430-1438","source":"Crossref","is-referenced-by-count":13,"title":["Factors Associated With Residual Disease in Axial Spondyloarthritis: Results From a Clinical Practice Registry"],"prefix":"10.3899","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3011-8547","authenticated-orcid":false,"given":"Casper","family":"Webers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0682-9533","authenticated-orcid":false,"given":"Annelies","family":"Boonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3792-7718","authenticated-orcid":false,"given":"Harald E.","family":"Vonkeman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8477-0683","authenticated-orcid":false,"given":"Astrid","family":"van Tubergen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2023,7,15]]},"reference":[{"key":"2023110700351054000_50.11.1430.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31591-4"},{"key":"2023110700351054000_50.11.1430.2","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223296"},{"key":"2023110700351054000_50.11.1430.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2014.10.009"},{"key":"2023110700351054000_50.11.1430.4","first-page":"4","article-title":"The burden of ankylosing spondylitis","volume":"78","author":"Boonen","year":"2006","journal-title":"J Rheumatol Suppl"},{"key":"2023110700351054000_50.11.1430.5","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.150037"},{"key":"2023110700351054000_50.11.1430.6","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-205178"},{"key":"2023110700351054000_50.11.1430.7","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210770"},{"key":"2023110700351054000_50.11.1430.8","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-213184"},{"key":"2023110700351054000_50.11.1430.9","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1093\/rheumatology\/keab516","article-title":"Treat-to-target in axial spondyloarthritis: an observational study in daily practice","volume":"61","author":"Beckers","year":"2022","journal-title":"Rheumatology"},{"key":"2023110700351054000_50.11.1430.10","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211734"},{"key":"2023110700351054000_50.11.1430.11","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.200934"},{"key":"2023110700351054000_50.11.1430.12","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1002\/acr.24369","article-title":"Systematic literature review of residual symptoms and an unmet need in patients with rheumatoid arthritis","volume":"73","author":"Michaud","year":"2021","journal-title":"Arthritis Care Res"},{"key":"2023110700351054000_50.11.1430.13","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1093\/rheumatology\/kex183","article-title":"Residual disease activity in psoriatic arthritis: discordance between the rheumatologist\u2019s opinion and minimal disease activity measurement","volume":"57","author":"van Mens","year":"2018","journal-title":"Rheumatology"},{"key":"2023110700351054000_50.11.1430.14","doi-asserted-by":"crossref","first-page":"3165","DOI":"10.1093\/rheumatology\/keaa766","article-title":"Measuring disease activity in psoriatic arthritis: PASDAS implementation in a tightly monitored cohort reveals residual disease burden","volume":"60","author":"Mulder","year":"2021","journal-title":"Rheumatology"},{"key":"2023110700351054000_50.11.1430.15","doi-asserted-by":"crossref","unstructured":"D\u2019Angelo S , Salvarani C , Marando F , Residual disease in patients with axial spondyloarthritis: a post-hoc analysis of the QUASAR study. 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