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 quality of life and identify associated factors in early SpA.
Methods Observational prospective study (2008-2011). Patients aged 45 years or below, attended in the SRU, reporting symptoms for 3-24 months (early), meeting the following criteria were included in the ESPeranza database: a) inflammatory back pain, or b) symmetric arthritis, or c) spine pain/articular pain, plus at least one of the following ones: a) psoriasis, b) inflammatory bowel disease c) anterior uveitis (AU), d) radiographic sacroiliitis, e) family history of spondylitis, psoriasis, IBD, or AU, f) HLA-B27 positive. 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 including: 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 using visual analog scale (VAS), patient’s night back pain (VAS), physician global assessment, enthesitis, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Schober 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 and ASQoL 7,1 + 4,95. Women reported worse quality of life compared with men (ASQoL 8.15 vs. 6.34; p<0.001) and patients with inflammatory back pain or sacroiliitis compared with those without them (ASQoL 7.60 vs. 6.12; p=0.001 and ASQoL 8.73 vs 6.62; p<0.001, respectively). Quality of life (ASQoL), in the linear multivariate regression models showed statistically significant association (Spearman Rho, P value) with disease activity measured using: ASDAS b (2.84, <0.001), ASDAS c (2.66, <0.001), BASDAI (1.56, <0.001), patient’s global assessment (1.21, <0.001), physician’s global assessment (0.96, <0.001), patient’s night back pain (0.81, <0.001), enthesitis (0.84, <0.001), ESR (0.62, <0.001) and BASFI (1.64, <0.001). BASRI and Schöber Index were not associated with quality of life.
Conclusions In patients with early SpA quality of life is impaired, and is associated with disease activity, but not with radiological scores. 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