Axial Spondyloarthritis (axSpA) Epidemiology

Key Highlights

• Axial spondyloarthritis (axSpA) is a multifactorial disease primarily affecting the sacroiliac joints and spine. It is associated with bone resorption and abnormal bone deposition, which can lead to ankylosis. Its pathogenesis is influenced by genetic, immunological, mechanical, and bioenvironmental factors.
• The most notable genetic risk factor is the HLA-B27 allele, though the disease can develop without its presence. Other important genes include those encoding interleukin-23 receptor and ERAP1.
• AxSpA includes two main subtypes: nonradiographic axial-SpA (nr-axSpA) and radiographic axial-SpA (r-axSpA). Non-radiographic axial-SpA may evolve into radiographic axial-SpA over time, with 10-40% of patients progressing to ankylosing spondylitis within 2-10 years.
• Diagnosing axSpA requires a combination of clinical, laboratory, and imaging evaluations, as no single test is definitive. MRI is especially valuable in early stages where X-rays do not show structural damage but can detect bone marrow edema, signaling ongoing inflammation. X-rays are used to assess structural damage in more advanced stages.
• Significant progress has been made in understanding the genetic and immunological mechanisms behind axSpA, including the role of cytokine networks and cellular pathways involved in chronic inflammation and abnormal bone formation. These advancements have led to the development of more targeted and effective treatments, improving patient outcomes.
• As per Delveinsight, the total number of prevalent cases of Axial Spondyloarthritis in the 7MM was ~4 million in 2023.
• In 2023, the US had the highest number of prevalent cases of axSpA, approx. 2.5 million, followed by the EU4 and the UK.

DelveInsight’s  “Axial Spondyloarthritis – Epidemiology Forecast – 2034” report delivers an in-depth understanding of Axial Spondyloarthritis, historical and forecasted epidemiology in the United States, EU4 (Germany, France, Italy, and Spain) and the United Kingdom, and Japan.

The table given below further depicts the key segments provided in the report:

Axial Spondyloarthritis: Disease Understanding 

Axial Spondyloarthritis Overview, and Diagnosis

Axial spondyloarthritis (axSpA) is an inflammatory arthritis that primarily affects the spine and sacroiliac joints, which connect the spine to the pelvis. It can also impact other joints and organs, making it a systemic condition. axSpA is more common in men, typically beginning between ages 20 and 40, and is often seen in families, suggesting its association with genetic component. The exact cause of axSpA is still unknown, but researchers believe that genetic factors, particularly the HLA-B27 gene, play a significant role. However, not everyone with the gene will develop the condition, suggesting environmental triggers such as infections may also contribute. The disease typically begins with pain and stiffness in the lower back, buttocks, and hips, but children may experience pain in the knees, heels, or hips.

Early diagnosis is essential to prevent long-term complications such as joint damage or fusion of the spine. Diagnosing axSpA involves a thorough evaluation by a healthcare professional. A primary care doctor may initially assess joint pain, but if axSpA is suspected, a rheumatologist is usually consulted. The diagnosis is based on a detailed medical history, physical examination, and various tests.

Although there is no cure for axSpA, early diagnosis and treatment are crucial to manage symptoms, prevent joint damage, and improve the quality of life. Treatment typically involves medications, physical therapy, and self-care strategies. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment to reduce pain and inflammation, while biologics, such as TNF inhibitors and IL-17 inhibitors, are used for more severe cases. Regular physical activity, including exercises like swimming, yoga, and walking, is recommended to maintain joint mobility and prevent stiffness. In severe cases, joint replacement or surgery to straighten the spine may be necessary. Managing axSpA requires a multidisciplinary approach, involving doctors, physical therapists, and other healthcare providers to improve outcomes and quality of life for those affected.

Axial Spondyloarthritis Epidemiology

The Axial Spondyloarthritis epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by Total Prevalent Cases of Axial Spondyloarthritis, Total Diagnosed Cases of Axial Spondyloarthritis, Gender-specific Cases of Axial Spondyloarthritis, Gene-specific Cases of Axial Spondyloarthritis, Age-specific Cases of Axial Spondyloarthritis, and Total Treated Cases of Axial Spondyloarthritis in the United States, EU4 countries (Germany, France, Italy, Spain) and the United Kingdom, and Japan from 2021 to 2034.

• The US accounts for the highest prevalent cases of Axial Spondyloarthritis, and about 60% of the total cases were from US in year 2023.
• Among the EU4 and the UK, Germany had the highest number of prevalent cases, followed by France and Italy. Spain reported the fewest cases.
• Compared to nr-axSpA, AS had a higher number of diagnosed cases.
• There is a notable gender difference between nr-axSpA and AS. Nr-axSpA, females account for a higher number of cases, while in AS, males represent a larger proportion of cases.
• HLA-B27 is the most common genetic marker for both nr-axSpA and AS, with ~700,000 cases reported across the 7MM in 2023.
• The total prevalent cases of Axial Spondyloarthritis in Japan was expected to reach ~25,000 by 2034.

Scope of the Report

• The report covers a segment of key events, an executive summary, and a descriptive overview of Axial Spondyloarthritis, explaining its causes, signs and symptoms, pathogenesis, and currently available therapies.
• Comprehensive insight into the epidemiology segments and forecasts, the future growth potential of diagnosis rate, and disease progression have been provided.
• A detailed review of current challenges in establishing diagnosis and diagnosis rate is provided.

Axial Spondyloarthritis Report Insights

• Patient Population
• Country-wise Epidemiology Distribution

Axial Spondyloarthritis Report Key Strengths

• Eleven-year Forecast
• The 7MM Coverage 
• Axial Spondyloarthritis Epidemiology Segmentation

Axial Spondyloarthritis Report Assessment

• Epidemiology Segmentation
• Current Diagnostic Practices

FAQs

Epidemiology Insights

• What are the disease risks, burdens, and unmet needs of Axial Spondyloarthritis? What will be the growth opportunities across the 7MM with respect to the patient population pertaining to Axial Spondyloarthritis?
• What is the historical and forecasted Axial Spondyloarthritis patient pool in the United States, EU4 (Germany, France, Italy, Spain) and the United Kingdom, and Japan?
• What is the diagnostic pattern of Axial Spondyloarthritis?
• Which clinical factors will affect Axial Spondyloarthritis?
• Which factors will affect the increase in the diagnosis of Axial Spondyloarthritis?
• Which age group has a high patient share in the Axial Spondyloarthritis?
• Which type of Axial Spondyloarthritis has a high patient share in the Axial Spondyloarthritis?
• Which gene type has a high patient share in the Axial Spondyloarthritis?

Reasons to buy

• Insights on disease burden, details regarding diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.
• To understand the change in Axial Spondyloarthritis cases in varying geographies over the coming years.
• A detailed overview of total cases of total prevalent cases of Axial Spondyloarthritis, total diagnosed cases of Axial Spondyloarthritis, gender-specific cases of Axial Spondyloarthritis, gene-specific cases of Axial Spondyloarthritis, age-specific cases of Axial Spondyloarthritis, and total treated cases of Axial Spondyloarthritisis included.
• To understand the perspective of key opinion leaders around the current challenges with establishing the diagnosis and insights on the treatment-eligible patient pool.
• Detailed insights on various factors hampering disease diagnosis and other existing diagnostic challenges.