Page 140 - Recognizing axial spondyloarthritis - Janneke de Winter

CHAPTER EIGHT
symptoms possibly relating to SpA. This suggestion is contradicted by the fact that the willingness to use preventive medication is not influenced by HLA-B27 status or by the presence of back pain. Moreover, data between participants and non-participants did not differ, suggesting that the data are representative for the study population. Third, despite being composed thoroughly, we might have not included all important variables in our study scenarios. For example, our study did not show a difference in willingness to use preventive medication between men and women, whilst in daily practice, women might fear becoming unfertile because of certain therapies. At some point we had to compromise between length and clarity of the survey and completeness.
In conclusion, when the axSpA risk is clearly increased (70%) or when preventive medication has no side effects, the vast majority of first-degree relatives of axSpA patients seems willing to use preventive medication. This willingness roughly drops by 50% by the possible occurrence of mild side effects.
Further research will have to focus on highly effective medication with an acceptable safety profile and on selecting individuals at clearly increased risk to develop SpA.
Acknowledgements: We acknowledge A.E.M. van Tillo-Klaver, I.A. Fluri and M. Leeuw for their help with this study.
The Pre-SpA cohort study is supported by the Dutch Arthritis Foundation (Reumafonds).
138