Background In recent years it has become increasingly important the evaluation of the global impact of the disease in patients with Spondyloarthritis (SpA) through the use of the Patient-reported Outcomes (PROs) (1). One of the most used PROs is the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, which refers to Health-Related Quality of Life (HRQoL). Since this is a subjective and multifactorial outcome (2), our goal is to detail the most important factors which are related with the Quality of Life (QoL) in these patients.
Objectives To evaluate QoL in patients with SpA and to define its association with disease-related factors and patient's features.
Methods A cross-sectional multicenter study which includes 2229 patients with SpA selected from the national Spondyloarthropaties Spanish Registry (REGISPONSER). The main outcome was the assessment of QoL performed through the ASQoL questionnaire. Subsequently, we studied its relation with different factors organized into 5 groups: sociodemographics, emotional, functionality, disease-related factors and disease activity. Univariate logistic regressions and a multiple linear regression (considering ASQoL as a qualitative dichotomous and quantitative variable respectively) were performed to relate QoL with the studied covariates.
Results The mean ASQoL score in the entire population studied was 6.09±5.12. The average age was 47.74±13.26 years old and 698 (31.31%) were women.
In univariate logistic regressions, significant differences (p<0.05) were seen in many variables included in the 5 groups: poor QoL (ASQoL≥9) is related with gender (female), age, mental and physical component from SF-12 questionnaire, disease duration, inflammatory back pain (IBP), alternating buttock pain, BASRI (Bath Ankylosing Spondylitis Radiographic Index), BASFI (Bath Ankylosing Spondylitis Functional Index), BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), ESR (Erythrocyte Sedimentation Rate) and global patient's VAS (Visual Analogue Scale), among others.
Finally, multivariate linear regression showed that 61.1% of the variability of ASQoL (R2 =0.611, p<0.001) is explained by sex (female), physical component and 2nd item form SF-12 questionnaire (related to functionality), 6th and 7th items form SF-12 (both related to mental status), global patient's VAS, BASFI and BASDAI.
Conclusions Poor QoL in SpA patients can be explained by high disease activity and by a deterioration in functionality and mental status. However, clinical form of SpA, disease duration and structural damage in spine do not explain this decrease of QoL.
Machado P, Landewé R, Braun J, Hermann KG, Baraliakos X, Baker D, et al: A stratified model for health outcomes in ankylosing spondylitis. Ann Rheum Dis 2011;70:1758–64.
Fernández-Carbadillo C, Navarro-Compán V, Castillo-Gallego C, Castro-Villegas MC, Collantes-Estévez E, de Miguel E. Disease activity is the major determinant of quality of life and physical function in patients with early axial Spondyloarthritis: Results from the ESPERANZA Cohort. Arthritis Care Res (Hoboken) 2016 Apr 25.1.
Disclosure of Interest None declared