Background Work productivity loss (WPL) and decreased health-related quality of life (HRQoL) are important problems for patients (pts) with chronic back pain. Not much is known about the relation between disease activity and WPL and HRQoL in pts with early onset axial SpondyloArthritis (axSpA).
Objectives To assess the relationship between disease activity and WPL and HRQoL in early axSpA.
Methods The SPACE cohort recruited pts (n=345) with chronic back pain (≥3 months, ≤2 years, onset <45 years) in 5 European centers. In pts fulfilling the ASAS axSpA criteria (n=131), the following assessments were done: ASDAS and BASDAI (disease activity), BASFI (functional ability), SF-36 (HRQoL) and Work Productivity and Activity Impairment (WPAI). Pts were grouped according to ASDAS: inactive disease (<1.3), moderate disease (1.3-2.1), high disease (2.1-3.5) and very high disease activity (>3.5). BASDAI and BASFI scores ≥4 were considered as high disease activity and impaired function, respectively. HRQoL was reported as the SF-36 physical (PCS) and mental component summary (MCS) scores (score of 50 (general population) ±10 (standard deviation; SD)). Impact of disease on work productivity (WP) was defined as percentage of absenteeism (absence from work due to illness), presenteeism (reduced productivity while at work) and WPL (combines absenteeism and presenteeism) in the past 7 days, with greater scores indicating greater impairment.
Results Figure 1a (n=122) shows that PCS score decreases significantly with increasing ASDAS state. PCS scores had a similar association when looking at low and high BASDAI (19.6 vs. 36.1, P<0.001) and BASFI scores (32.7 vs. 12.6, P<0.001). MCS is not influenced by disease activity (ASDAS states; P=0.97, low vs. high BASDAI; 45.9 vs. 48.0, P=0.37) or functional ability (low vs. high BASFI; 46.3 vs. 47.2, P=0.76). Figure 1b (n=100) shows that absenteeism (P=0.02), presenteeism (P<0.001) and WPL (P<0.001) increases as ASDAS increases. Similar findings are found when looking at pts with low vs. high BASDAI (absenteeism; 3.9% vs. 19.5%, presenteeism; 19.4% vs. 51.2%, WPL; 20.6% vs. 57.5%, all P-value<0.001) and BASFI (WPL; 30.9% vs. 66.7%, absenteeism; 7.1% vs. 24.9%, presenteeism; 28.9% vs. 61.1%, all P-value<0.001).
Conclusions In early axial SpA disease activity has a major impact on physical HRQoL and on work productivity. These findings support aiming for clinical remission in patients with early axial SpA.
Disclosure of Interest None declared