Accelerating the Diagnosis of axSpA in Canada: How FASTRAX is Reshaping the Patient Journey

UCB Canada - Leading the Way in Access, Innovation and Impact

At UCB Canada, our mission transcends the development of innovative medicines; we are dedicated to transforming the healthcare ecosystem to better serve patients. By forging strategic partnerships and embracing a patient-centric approach, we aim to elevate the standard of care and address unmet needs in the healthcare system—particularly for people living with conditions like axial spondyloarthritis (axSpA). With Spondyloarthritis Awareness Month recognized each May, it's a timely reminder of the need to close diagnostic gaps and champion earlier access to care all year round.

This vision is exemplified by our collaboration with rheumatology clinics across Ontario through the FASTRAX Canada program. FASTRAX is designed to accelerate the diagnosis of axial spondyloarthritis (axSpA). By doing so, we aim to reduce the average diagnostic delay of 7 to 9 years¹, ensuring patients receive timely and appropriate care.

As Rodrigo Reis, General Manager of UCB Canada, articulates, "We are not just developing treatments; we are developing solutions that encompass the entire patient journey." This holistic approach underscores our dedication to improving patient outcomes through innovation and collaboration.

Through initiatives like FASTRAX, UCB Canada is not only addressing current challenges in patient care but also setting a precedent for future healthcare innovations. Our goal is to create a more responsive, efficient, and patient-focused healthcare system that delivers meaningful improvements in people's lives.

Understanding the Delay: Why Timely Diagnosis of axSpA Matters

What is axial spondyloarthritis (axSpA)?

Axial spondyloarthritis is a chronic, inflammatory condition that often begins in early adulthood, causing persistent back pain, stiffness, fatigue, and reduced mobility. Yet for many patients, getting a diagnosis can take years. Early symptoms are frequently mistaken for mechanical back pain, leading to repeated misdiagnoses and a long journey through physiotherapy, chiropractic care, orthopedics, and pain clinics—without ever reaching the root cause⁵.

While inflammation continues unchecked, irreversible joint damage and diminished quality of life can set in². This is compounded by a national shortage of rheumatologists—only around 200 specialists serve all of Canada—resulting in long waits and limited access to timely referrals³. Women, Indigenous Peoples, and those in rural areas often face even greater delays, with added barriers to culturally safe, geographically accessible care^{4, 5}.

These aren’t just clinical barriers—they are human ones. Each delay represents time spent in pain, without answers, while the disease continues to progress in silence².

Why does it take so long to get diagnosed?

Many patients with axSpA, like Samantha, spend years searching for answers. In her late twenties, Samantha began experiencing daily back pain that wouldn’t go away. Over time, it grew worse—affecting her sleep, her ability to work, and her mental health. She did what most people would do: she sought help. But after visits to a chiropractor, a physiotherapist, and an orthopedic surgeon, she was still left without a clear explanation. It took more than four years for her to finally hear the words: axial spondyloarthritis.

Samantha’s story mirrors the experience of many Canadians living with axSpA. On average, people wait seven to nine years for a diagnosis¹. The reason? It’s not always obvious what’s wrong. Inflammatory back pain caused by axSpA can resemble mechanical pain, leading to frequent misdiagnosis or dismissal in primary care settings². Awareness of axSpA among non-specialists remains limited, and access to specialists is even more so—Canada has only about 200 practicing rheumatologists across the entire country³. For women, Indigenous patients, and those living in rural or remote communities, the barriers are even greater⁴. The system simply isn’t designed to catch this disease early.

These delays have consequences. In the absence of a diagnosis, inflammation progresses unchecked—damaging joints, reducing mobility, and taking a toll on mental and emotional well-being⁶. By the time many patients are diagnosed, they’ve lost more than just time—they’ve lost opportunities to preserve function, protect their quality of life, and plan for their futures.

What happens during those years of delay?

For Samantha, the years between her first symptoms and her diagnosis were filled with more than just unanswered questions—they were filled with escalating pain, disrupted routines, and growing uncertainty. Without a clear explanation, it became harder to advocate for herself at work, in social settings, and even in future planning. The inflammation in her body continued unchecked, silently causing damage while outwardly being misunderstood.

This is the reality for many patients living with undiagnosed axSpA. The longer the disease goes unrecognized, the more it chips away at daily life—compromising mobility, eroding mental health, and creating strain across every aspect of well-being⁶. Chronic pain can make even basic tasks exhausting. The emotional toll of being disbelieved or misdirected adds to the burden. And in some cases, irreversible changes such as spinal fusion can occur, limiting movement and increasing disability.

Most patients describe it best as:

“The most painful thing? You don't really feel heard or seen. Most doctors don't see young people as having something more chronic or having an underlying problem.” 

These aren’t just lost years—they’re years of avoidable harm. Years when the right diagnosis could have made all the difference.

Why is early diagnosis so important?

When axSpA is identified in its early stages, patients have access to treatments—like biologics—that can reduce inflammation, manage symptoms, and help prevent irreversible joint damage⁵. It also opens the door to support systems that address both the physical and emotional impact of the disease. Early diagnosis not only improves health outcomes, it also reduces strain on the healthcare system by minimizing unnecessary tests, referrals, and emergency visits.

For Samantha, finally being diagnosed marked the end of confusion—and the beginning of a plan. And for thousands of Canadians living with undiagnosed axSpA, that moment can’t come soon enough.

What’s the bottom line?

Every year without a diagnosis is a year without answers. The longer axSpA remains undetected, the harder it becomes to control—and the greater the toll on patients’ lives.

It’s time to close the diagnostic gap. Patients deserve to be heard, believed, and treated earlier. Programs like FASTRAX are helping lead the way.

For Canada’s healthcare system, earlier axSpA diagnosis reduces unnecessary referrals, imaging, and late-stage care⁷. These efficiencies are critical amid ongoing health system pressures, including a shortage of primary care providers and rheumatologists, limited MRI access, and growing demand across regions. In this context, programs like FASTRAX help relieve system strain by streamlining access to timely, targeted care⁸.

Please note that Samantha’s journey is hypothetical and represents a generalized patient story.

Introducing FASTRAX: A New Standard for a Timely Diagnosis

FASTRAX is UCB’s patient-centric innovation program in axSpA aimed at halving time to diagnosis for Canadians with axSpA. It is built on a multi-stakeholder, evidence-based model that accelerates the diagnostic journey through a streamlined assessment process.

How FASTRAX is Transforming the Diagnostic Journey:

1. Addressing Diagnostic Breakpoints Across the Patient Journey

FASTRAX is designed to intervene at key breakpoints along the axSpA diagnostic pathway—where patients most commonly get delayed or misdirected. Rather than focusing on a single care setting, the program streamlines the entire journey by engaging interprofessional teams and enabling targeted referrals. This system-wide approach helps reduce unnecessary visits, testing, and specialist delays, ensuring patients are directed toward appropriate care sooner.

2. Advanced Clinical Assessment

Once patients are identified, they are referred to Advanced Clinician Practitioners in Arthritis Care (ACPAC), who are highly trained physiotherapists authorized to perform diagnostic assessments under medical directives. These ACPACs collaborate closely with rheumatologists, using their advanced scope of practice and medical directives to order tests such as MRIs and blood test screenings. By enabling faster triage and early testing, their involvement increases clinical capacity within rheumatology, helping ensure patients are assessed more efficiently and directed to appropriate next steps in their care.

3. Interdisciplinary Team Collaboration

FASTRAX functions as a cohesive, interprofessional model of care involving rheumatologists and ACPACs. This ecosystem approach ensures that patients are supported by a collaborative network, wait times are reduced, and system efficiency is improved. As a result, more patients receive timely assessments and access to specialized treatment, alleviating pressure on overburdened rheumatology clinics.

FASTRAX in Action: Driving Measurable Change and Health System Transformation

FASTRAX is a scalable innovation model built for long-term integration within provincial health systems.

Ontario Provincial Program

Developed and led a by single interprofessional rheumatology team in downtown Toronto, the axSpA Screening Clinic model has served as the foundation for FASTRAX. With support and funding from UCB Canada, it has since expanded into a multi-site initiative focused on ensuring that every patient in Ontario—regardless of location—has timely access to the care and diagnosis they deserve. It is now active in Toronto, where the original clinic established its evidence-based foundation. The program has since expanded to Ottawa, addressing high-referral volumes in Eastern Ontario, and to Thunder Bay, where it helps bridge equity gaps for Indigenous and rural communities in Northern Ontario. Together, these sites form the foundation of a province-wide strategy to transform access to axSpA care and bring a timely diagnosis to more Canadians.

Initial Outcomes

The impact of FASTRAX is already being felt in the regional patient populations where it has launched. By expanding access points and streamlining referrals, the program is helping more patients in Ontario—including those in urban, rural, and remote communities—navigate the diagnostic journey with greater clarity and continuity. Patients who may have otherwise faced long, complex paths to specialist care are now being identified earlier and connected to the right resources sooner, creating momentum toward more equitable and timely axSpA diagnosis.

These efficiencies have also led to increased clinic capacity, enabling rheumatologists to focus on more complex cases, while ACPACs manage high-quality triage and screening. As one Canadian rheumatologist once said, “By receiving high-quality, pre-screened referrals through FASTRAX, we can focus our time on complex cases and trust that patients are already on the right path. It’s transformed how we manage our clinic flow.”

This model not only supports physicians but enhances patient satisfaction by delivering more coordinated, timely care across the continuum.

Looking Ahead: UCB Canada's Vision for Innovation, Access and Systemic Change

FASTRAX is more than a program—it’s a reflection of UCB Canada’s long-term vision for healthcare innovation and our commitment to transforming access to care across diverse communities. As we look ahead, our priorities are clear:

We are working to close longstanding equity gaps by reaching patients in rural, Indigenous, and underserved areas—leveraging community partnerships and virtual models of care to bring screening and support where it’s needed most.

We are focused on scale with sustainability in mind. By demonstrating the real-world impact of FASTRAX, we aim to work hand-in-hand with the Ministry of Health to embed this model as a recognized standard of care in Ontario and beyond⁸.

And we are committed to measuring what matters. Through a UHN-led, multi-site provincial study⁷, we are generating the evidence needed to validate FASTRAX’s system-level benefits and support future health system integration.

Shaping the Future of axSpA Care in Canada

At its core, FASTRAX reflects UCB Canada’s unwavering commitment to solving real-patient challenges through collaborative, scalable and inclusive innovation. By bridging the gap between patients and their diagnosis, empowering healthcare providers, and partnering with provincial systems, UCB is laying the foundation for a future where a diagnosis comes earlier, treatment is more accessible, and the patient journey is defined by dignity, clarity and care.

For patients, every year without a diagnosis is a year without answers. UCB Canada is determined to change that — one system, one partnership, one patient at a time.

Earlier this year, during SpA Awareness Month, Canadians came together to raise awareness of the challenges people with axial spondyloarthritis face every day. Through initiatives like the Canadian Spondyloarthritis Association’s “Lace Up for axSpA” campaign, communities across the country shared stories, drove advocacy and reinforced the urgent need for faster, more equitable diagnosis.

That momentum doesn’t stop with a single month. UCB Canada remains committed to advancing the work started during SpA Awareness Month — supporting innovative models like FASTRAX, advocating for earlier diagnosis and helping shape a healthcare system where no patient waits years to be heard.

To learn more about axSpA and how to get involved, visit the Canadian Spondyloarthritis Association.