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  1. Filipe Araújo1,
  2. Claudia Duarte2,
  3. Jorge Brandão3,
  4. Rui Cernadas4,
  5. Elsa Mateus5,
  6. Luís Cunha Miranda6,
  7. José Canas Da Silva7,
  8. José Gomes Da Silva8,
  9. Pedro Simões Coelho2,
  10. Catarina Marques9
  1. 1Hospital Sant’Ana, Rheumatology and Osteoporosis Unit, Lisbon, Portugal
  2. 2NOVA IMS Information Management School, Lisbon, Portugal
  3. 3APMGF – Associação Portuguesa de Medicina Geral e Familiar, Delegação Distrital de Coimbra, Coimbra, Portugal
  4. 4Serviços Médicos Continental, Lisbon, Portugal
  5. 5Liga Portuguesa Contra as Doenças Reumàticas, Lisboa, Portugal
  6. 6IPR – Portuguese Institute of Rheumatology, Lisbon, Portugal
  7. 7Hospital Garcia de Horta, Lisboa, Portugal
  8. 8National Association of Ankylosing Spondylitis, Oeiras, Portugal
  9. 9Portuguese League Against Rheumatic Diseases, Lisbon, Portugal


Background: AS is known to have a significant burden upon the individual, family and society. It is essential to assess the impact of AS in patients’ lives, to raise awareness and improve early referral, diagnosis and treatment, for a better quality of life.

Objectives: To assess the impact of AS in the life of Portuguese patients (work, daily activities, social life).

Methods: The Assessment of REsults in Ankylosing spondylitis (arEA) study was developed by the NOVA-IMS in cooperation with: Portuguese Society of Rheumatology, Portuguese Association of Family Physicians, National Association of Primary Care Units, National Association of AS Patients and the Portuguese League Against Rheumatic Diseases. The arEA aimed at assessing reasons for delayed referral of suspicious cases of AS to the rheumatologist, as well as disease impact in patients’ lives, global health and work. A comprehensive online survey was developed with the collaboration of LPCDR and sent to AS patients. Data on demographics, lifestyle habits, daily life activities, working habits, disease indexes and healthcare utilization, health status/quality of life indicators, EQ-5D and BASDAI scales. A generalized linear model was adjusted in order to identify the factors impacting on quality of life of patients.

Results: 354 patients responded the survey, 42.1% female, most frequently from the 35-44 year-old age group. Mean age at disease onset was 27 years old, while the diagnosis was confirmed 7 years later. In the previous 12 months, the average of working days lost due to AS issues was 37 (including sick leaves). During that period, AS has affected work productivity in average around 73 days. Cumulatively, patients’ relatives or friends had also lost about 13 days of work, to provide them assistance. Regarding limitations in daily life activities, house cleaning (55.5%), physical exercise (46.5%), getting in/out of bed (45.6%), using stairs (37.9%), shopping (37.4%) and tying shoes (35.2%) were reported as being highly limited by AS. As for the social life, family and friends’ relationships were reported as not being affected by over 60% of AS patients. However, 19.8% of the respondents have reported a worse relationship with their partners after diagnosis, and 29.7% reported having decreased the frequency of sexual intercourse. Leisure activities, were only reported as not being affected by 34.6% and 40.5% of patients, while the practice of sports has much decreased in 40.7% of the respondents. Almost 80% had mobility issues during the last year, and over 65% had their usual activities/routines affected by AS. The average BASDAI score is 5.5 and the EQ visual analogue scale 55. Analyzing the impact of treatment, biologics and biosimilars were reported as having significantly improved patients’ quality of life, except for physical or sexual activity.

Conclusion: AS has a major impact in the daily life of patients, work productivity, social relationships and leisure activities. Early diagnosis and treatment, along with physical rehabilitation/exercise plans, can reduce this impact and improve their quality of life.

Disclosure of Interests: None declared

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