Background: Therapeutic compliance is a key element in the management of patients with spondyloarthritis, as it directly impacts treatment outcomes and overall disease control. However, adherence to prescribed therapies is often influenced by a variety of factors, including psycho-cognitive aspects.

Objectives: The aim of this study is to assess adherence to biotherapies in these patients, the prevalence of catastrophizing, fibromyalgia, anxiety and depression, and their impact on treatment adherence.

Methods: This is a bicentric cross-sectional study carried out at El Ayachi Hospital. Patients followed for spondyloarthritis, according to ASAS 2009 criteria, and receiving biological treatment for at least 03 months were included in the study. Data were collected using a pilot-tested and validated Google Forms questionnaire. The questionnaire included information on socio-demographic parameters, disease activity scores, as well as an assessment of therapeutic compliance using the Girerd score (GS). Anxiety disorders were assessed by the Hospital Anxiety and Depression Scale (HAD), fibromyalgia by the Fibromyalgia Rapid Screening Tool (FIRST), and pain catastrophizing by the Pain Catastrophizing Scale (PCS).

Results: We included 110 patients with spondyloarthritis, with a mean age of 39.2 ± 11.9 years, 55.5% of whom were men. Regarding treatment, 82.6% were on anti-TNF, of whom 31.8% were receiving infliximab, 22.7% adalimumab and 14.5% etanercept. A further 16.4% were treated with anti-IL-17 and 0.9% with anti-JAK. Compliance was good (GS = 0) in 53.6% of patients, while 46.4% had compliance problems (GS ≥ 1). The prevalence of psycho-cognitive factors in our population was 15.5% for catastrophism, 11.8% for fibromyalgia, 5.5% for anxiety and 17.3% for depression. There was no significant difference in age between the two groups (mean age: 38.9 ± 11.9 years for GS = 0 vs. 39.5 ± 12.0 years for GS ≥ 1; p = 0.808). Moreover, compliance was not significantly different by gender (51% for GS = 0 in men vs. 59% for GS ≥ 1 in women; p = 0.070). In multivariate analysis, neither anxiety nor depression appeared to be affecting adherence therapeutic (OR = 0.210; 95% CI 0.02 - 1.91; p = 0.168 and OR = 0.623; 95% CI 0.22 - 1.73; p = 0.363, respectively). Similarly, catastrophism showed no significant impact (OR = 0.780; 95% CI 0.273 - 2.22; p = 0.641), as did fibromyalgia (OR = 1.405; 95% CI 0.440 - 4.49; p = 0.566).

Conclusion: This work highlights a real problem of therapeutic compliance with biotherapies in patients with ankylosing spondylitis (AS). Importantly, psychocognitive factors do not appear to have a significant impact on poor compliance. These results further underline the need to set up therapeutic education programs to raise patients’ awareness of the importance of good compliance, essential for better disease management.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.