Background The aim of the ESPeranza program was to provide an early and effective access to rheumatologic care for patients with spondyloarthritis (SpA). Specific Rheumatologic Units (SRU) for an early evaluation, treatment and follow up of patients with SpA were established in 25 Spanish hospitals.
Objectives To describe physical function and identify associated factors in early SpA.
Methods Observational prospective study (2008-2011). Patients aged <45 years, attended in the SRU, reporting symptoms for 3-24 months (early), meeting the following criteria were included in the ESPeranza database: inflammatory back pain, or symmetric arthritis, or spine pain/articular pain, plus at least one of the following ones: psoriasis, inflammatory bowel disease, anterior uveitis (AU), radiographic sacroiliitis, family history of SpA, psoriasis, IBD, or AU, HLA-B27 +. For the purpose of this sub-study, we selected patients who also met AMOR and/or ESSG criteria. Sociodemographic variables (sex, age, work status), clinical variables as Ankylosing Spondylitis (AS), Disease Activity Score (ASDAS), Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Radiology Index (BASRI), patient global assessment measured by visual analog scale (VAS), patient’s night back pain (VAS), physician global assessment, enthesitis, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Schöber index, and Ankylosing Spondylitis Quality of Life (AsQoL) were collected. Descriptive and bivariate analyses were performed.
Results A total of 726 patients were analyzed (60% men, mean age 33 years, 13% work disabled). Mean ± standard deviation of main clinical variables were: ASDAS b 2,35±1,04; BASDAI 4,5±2,2; patient’s global assessment 5,23 + 2,53; physician’s global assessment 3,88 + 2,1; BASFI 2,7 + 2,25. Patients with inflammatory back pain or sacroiliac syndrome reported worse physical function compared with those without them (BASFI 2.89 vs. 2.36; p=0.006 and BASFI 3.37 vs. 2.52; p<0.001 respectively) and women compared with men (BASFI 3.08 vs. 2.44; p<0,001). Physical function (BASFI), in other bivariate models showed statistically significant association (correlation coefficient and p value) with disease activity measured using ASDAS b (1.30, <0.001), ASDAS c (1.25, <0.001), BASDAI (0.68, <0.001), patient’s and physician’s global assessment (0.54, <0.001 y 0.46, <0.001), patient’s night back pain (0.38, <0.001), enthesitis (0.42, <0.001), ESR (0.03, <0.001), Schöber (-0.19, <0.001) and ASQoL (0.35, <0.001).
Conclusions Even in early stages of SpA physical function is impaired and is strongly associated with disease activity. Compared with men, women with early SpA reported worse quality of life.
Disclosure of Interest C. Fernández-Carballido Grant/Research support from: Esperanza Program has been supported by an unrestricted grant from Pfizer, M. Gobbo: None Declared, C. Martínez: None Declared
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