PROJECT TITLE
The APLAR Spondyloarthritis (SpA) Registry
ABSTRACT AND SIGNIFICANCE OF THE PROJECT

Abstract
Spondyloarthritis (SpA) is a group of chronic, systemic inflammatory disease and incurs substantial economic burden to the society, in terms of both healthcare resources consumption and productivity losses due to work capacity impairment. Despite extensive evidence concerning the importance of early diagnosis and intensive treatment of SpA, in practice, treatment for patients with early SpA are often delayed because of limited access to rheumatologic care, while the management of SpA is normally base on physician’s decision or standard of care. A SpA clinic providing early assessment, accurate diagnosis and protocolized tight control treatment may overcome the hurdle and improve the outcome of these patients.

The APLAR SpA Registry is a multi-center study aiming to build up a platform for SpA registry for long term outcome including disease activity, damage and comorbidity, and to enhance research and management of the disease. The registry data might also provide insight for improvement of health-care policy.

The registry is developed in two phase. Phase I is a cross-sectional study as a snapshot of disease characteristics across APLAR region. Phase II is a 5-year prospective cohort study. Subjects will be recruited from the participating center. Subject will undergone specific treatment strategy and individual treatment goal. The goal for psoriatic arthritis subjects will be achieving minimal disease activity while the goal for subject with axial SpA will be moderate to inactive disease (ASDAS<2.1). Data on demographics, medical history, clinical features, drug use, co-morbidities as well as patient-reported-outcome will be collected. The primary outcome of the study is the percentage of patients achieving MDA for PsA subject with peripheral arthritis and achieving moderate-inactive disease for axial SpA at 1 year.

Significance
Results from this study provide important estimates for the future economic modeling to investigate the utility of early diagnosis and intensive protocolized treatment to patients with SpA. Results from this study will be both clinical and policy-developing relevant. It provides evidence on the utility of early diagnosis and intensive treatment of SpA as a routine rheumatological practice, which could facilitate the development of government policy on the basis of affordability. It could provide information to support the political process and help policy decision makers optimize healthcare resources allocation.