Disease activity: major determinant of quality of life and physical function in axial spondyloarthritis
Axial spondyloarthritis (axSpA) can be defined as a chronic inflammatory disease mainly affecting the axial skeleton (sacroiliac joints and spine). It impairs the quality of life of patients. However, there has been limited research on axSpA patients in clinical practice and the impact of the disease on patient’s health-related quality of life (HrQoL)
Recently, a cohort study was conducted that defined HRQoL and physical function (PF) in patients with early axial Spondyloarthritis (axSpA) and to evaluate their links with disease activity and radiographic damage. This was a cross sectional study, drawing upon baseline data of axSpA patients (ASAS criteria) from the ESPERANZA cohort. In order to assess the link between disease activity and radiographic damage (spine and sacroiliac joints) with HRQoL, PF and spinal mobility (SM), linear regression analyses were used.
A total of 259 patients were involved in study. Mean (SD) age was 32.2(6.9) years; disease duration 13.3(6.8) months; ASQoL, 5.9(4.8); BASFI, 2.4(2.3); BASMI, 1.4(1.3); BASDAI, 3.8(2.3); CRP, 9.7(13.2) mg/L and BASRI-spine, 1.7(1.6). On univariate analysis, HRQoL was found to be chiefly linked with disease activity (β values for BASDAI 0.646, patient global VAS 0.641, night back pain VAS 0.598, physician VAS 0.560 and CRP 0.275; all p< 0.01) while the association with radiographic damage was found to be weaker (Std β for BASRI-spine 0.142, p<0.05). During multivariate analyses, HRQoL was found to remain considerably linked with disease activity (Std β for BASDAI 0.330; p<0.01 and physician VAS 0.205 and night back pain VAS 0.210; p=0.01). Likewise, PF was found to be linked with disease activity and radiographic damage on univariate analysis, but only with disease activity (BASDAI β:0.466; p<0.01) on multivariate analysis. However, SM was associated with radiographic damage in both, univariate and multivariate analyses.
QoL and PF function are already compromised in patients with axSpA at the commencement of their disease course. The current findings provided a strong evidence about a sturdy association with disease activity in such patients.