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International Journal of Rheumatology
Volume 2009, Article ID 268569, 10 pages
Research Article

Ankylosing Spondylitis Patients Commencing Biologic Therapy Have High Baseline Levels of Comorbidity: A Report from the Australian Rheumatology Association Database

1Monash Department of Clinical Epidemiology, Cabrini Institute, 183 Wattletree Road, Malvern, VIC 3144, Australia
2Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, VIC 3004, Australia
3Austin Spondylitis Clinic, Austin Health, Studley Road, Heidelberg, VIC 3084, Australia
4Centre of Clinical Research Excellence in Therapeutics, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, VIC 3800, Australia
5School of Physiotherapy, Curtin University of Technology, WA 6000, Australia
6Department of Rheumatology, St George Hospital, NSW 2217, Australia
7Department of Rheumatology, Royal North Shore Hospital, NSW 2065, Australia
8Institute of Bone and Joint Research, University of Sydney, NSW 2065, Australia

Received 13 April 2009; Accepted 28 May 2009

Academic Editor: Malcolm D. Smith

Copyright © 2009 John Oldroyd et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Aims. To compare the baseline characteristics of a population-based cohort of patients with ankylosing spondylitis (AS) commencing biological therapy to the reported characteristics of bDMARD randomised controlled trials (RCTs) participants. Methods. Descriptive analysis of AS participants in the Australian Rheumatology Association Database (ARAD) who were commencing bDMARD therapy. Results. Up to December 2008, 389 patients with AS were enrolled in ARAD. 354 (91.0%) had taken bDMARDs at some time, and 198 (55.9%) completed their entry questionnaire prior to or within 6 months of commencing bDMARDs. 131 (66.1%) had at least one comorbid condition, and 24 (6.8%) had a previous malignancy (15 nonmelanoma skin, 4 melanoma, 2 prostate, 1 breast, cervix, and bowel). Compared with RCT participants, ARAD participants were older, had longer disease duration and higher baseline disease activity. Conclusions. AS patients commencing bDMARDs in routine care are significantly different to RCT participants and have significant baseline comorbidities.