Background Ankylosing spondylitis (AS) is associated with work productivity loss (WPL) and decreased health-related quality of life (HRQoL). Few publications on HRQoL and work productivity (WP) in early axial spondyloarthritis (axSpA) are available.
Objectives To determine the impact of chronic back pain (CBP) of recent onset on HRQoL and work productivity in young patients (pts).
Methods The SPondyloArthritis Caught Early (SPACE)-cohort includes pts with CBP (≥3 months, ≤2 years, onset <45 years) in 5 European centers (n=345). Pts who met the ASAS axial SpA criteria were classified as axSpA (n=131). Pts with 1 SpA feature were defined as possible SpA (n=167), and those with no SpA features as no SpA (n=47). AxSpA was further differentiated into modified New York criteria positive, with or without sacroiliitis on MRI (mNY+, n=26), sacroiliitis on MRI only (n=46) and patients fulfilling the clinical arm of the ASAS criteria (n=59). The 36-item Short-Form (SF-36) and Work Productivity and Activity Impairment (WPAI) surveys were administered to determine HRQoL and WP. SF-36 physical (PCS) and mental component summary (MCS) scores were compared to age and sex-matched scores from the general population (score of 50±10 SD represents the general population mean ± standard deviation (SD)). Impact of disease on 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) over the past 7 days, with greater scores indicating greater impairment.
Results In total, 304 pts had completed the SF-36 and 230 the WPAI. Figure 1 shows a reduction of ≥2 SD in mean PCS scores in all subgroups compared to the general population. Within axSpA, PCS was lowest in mNY+ (25.8), followed by pts with sacroillitis on MRI (27.0) and pts in the clinical arm (30.2). Mean MCS approximated the general population mean (range 45.4 (sacroiliitis on MRI only)-50.3 (mNY+)). Mean % absenteeism was highest in no SpA and possible SpA (21.6% and 18.5%; P=0.10 and P=0.05, compared to axSpA 10.3%) and lowest in clinical arm and mNY+ (7.6% and 9.9%). Presenteeism was highest in no SpA and possible SpA (46.9% and 44.7%; P=0.04 and P=0.02, compared to axSpA 34.7%), and lowest in the axSpA subgroups (range 33.9-35.6%). WPL was highest in no SpA and possible SpA (55.2% and 48.3%; P=0.01 and P=0.02 compared to axSpA 37.5%), and ranged in axSpA from 34.6% (clinical arm) to 40.4% (sacroiliitis on MRI).
Conclusions WP and physical HRQoL are greatly reduced in young pts with CBP. Even more in pts with no SpA and possible SpA than pts with axial SpA, while in axSpA pts, pts with sacroiliitis (mNY+ and/or MRI) had the largest impact.
Disclosure of Interest : None declared
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