FASTRAX working session highlights progress in axSpA diagnosis

A collaborative working session in London compares country-specific approaches to reducing diagnostic delays in axial spondyloarthritis

On June 2, healthcare professionals from across Europe and North America gathered in London for a FASTRAX healthcare professional collaborative working session, ahead of the European Alliance of Associations for Rheumatology (EULAR) congress. FASTRAX is a program designed to address the critical issue of delayed diagnosis of axial spondyloarthritis (axSpA), a type of chronic inflammatory arthritis in the lower back. 

The session brought together clinicians, researchers and the UCB Digital Care Transformation (DCTx) teams to share real‑world implementation experiences from FASTRAX initiatives across Canada, France and the United Kingdom. Discussions focused on how earlier identification and coordinated care pathways can improve outcomes for people living with axSpA. The session centered on practical insights while also highlighting opportunities for cross‑country collaboration and scientific exchange. 

Understanding the care coordination challenge

Axial spondyloarthritis is often associated with significant diagnostic delays.i Evidence presented during the session showed that patients may wait for years between early symptoms and a formal diagnosis, during which time disease burden can increase and opportunities for earlier care and support may be missed.

Retrospective primary care data presented during the session showed that, in France, there is an average delay of 6.3 years between the earliest documented back pain in primary care and diagnosis, with the number of symptoms and comorbidities increasing over that period.ii

This reflects broader system‑level barriers. Clinicians discussed how overlapping symptoms with common conditions such as mechanical back pain, variable awareness in primary care and fragmented referral pathways can delay access to diagnostic and rheumatology services

These challenges reflect DCTx’s broader focus on strengthening identification and referral pathways, so patients reach specialist care more efficiently in real‑world settings. 

FASTRAX in practice: different approaches, shared objectives 

Across countries, FASTRAX initiatives are designed to address barriers in practical and locally relevant ways, while sharing the same objective: to enable earlier recognition of disease and improve how patients navigate care pathways:  

• Strengthening early assessment in Canada: An interprofessional model integrates advanced practice clinicians (Such as ACPAC (Advanced Clinician Practitioners in Arthritis Care)) into early assessment and triage, with experience to date suggesting that these teams can support timely evaluation while adapting to local workforce capacity and access to specialists
• Supporting recognition in primary care in France: Digital prompts have been embedded in routine workflows, guiding general practitioners (GPs) in assessing key clinical features and referral where appropriate, addressing inconsistent identification of inflammatory back pain
• Extending support into long-term management in the United Kingdom: Digital platforms integrated into rheumatology services enable remote symptom reporting, helping clinicians identify who may need follow‑up, while balancing service demand and clinical capacity

These examples show how the same ambition can be adapted to different local health system needs, workforce models and digital infrastructure. 

Identifying where shared learning can accelerate progress  

The London session helped elevate the discussion beyond individual country experiences and identify where shared learning can accelerate progress. Common themes included barriers to early referral from primary care, access to timely diagnostics and the challenge of overstretched practices being asked to do more with less. The group also discussed opportunities for scientific collaboration and real-world evidence generation to better understand how pathway innovations work in practice. 

What does this mean for patients? 

For patients living with axSpA, earlier diagnosis can have a meaningful impact on disease management and quality of life. One of the key learnings from this session was that progress does not depend on every country adopting the same model. What matters is designing approaches that fit local systems while still helping patients access specialist care sooner.

The approaches discussed during the session point to a shared set of principles: understanding where patients are delayed, embedding support into existing workflows, and using digital tools or new care models to help healthcare professionals make timely, informed decisions.

Applying FASTRAX learnings across healthcare systems  

This event demonstrated that improving diagnosis and care pathways requires both local innovation and shared learning. By bringing together stakeholders across countries and disciplines, the session highlighted the value of moving from standalone digital solutions toward care models shaped by real-world clinical needs and tested in practice.

As the FASTRAX community continues to grow, the focus remains on translating real‑world insights into practical improvements that matter to patients and help ensure that people with suspected axial spondyloarthritis can access the right care, at the right time.