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Patients with well-established ankylosing spondylitis show limited deterioration in a ten-year prospective cohort study

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Abstract

This study aims to describe the deterioration of well-established ankylosing spondylitis (AS) over a 10-year period. Patients with well-established AS under secondary care review were assessed at baseline and re-assessed after a 10-year period. Data on patient characteristics, spinal mobility and self-reported health status (AS Quality of Life, Bath AS Disease Activity Index, EuroQoL, Revised Leeds Disability Questionnaire and Short Form-12) were compared between the two time points. One hundred fifty-nine patients took part in the initial assessment. After 10 years, 69/117 patients still under secondary care follow-up attended a second assessment. At the second assessment, this cohort was predominately male (92.8 %), mean age of 48.7 years (SD 9.7) and mean disease and symptom duration of 14.9 (SD 9.0) and 21.9 years (SD 13.3), respectively. Amongst the physical and patient-reported measures, only tragus to wall (p < 0.001), cervical rotation (p = 0.001) and disability (p = 0.02) had significantly deteriorated over time. The percentage of patients who had withdrawn from the workforce before normal retirement age increased from 37 to 53 % over the 10-year period. Many of the measures used in the assessment of AS do not generally deteriorate over time in those with well-established disease. This suggests that deterioration may plateau in established disease. However, AS has a long-term social impact with levels of employment in this cohort 30 % lower than the general population. Interventions directed at preventing deterioration may be more effective earlier in their disease course, before this plateau is reached.

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Acknowledgments

The authors wish to thank all the patients who participated in the study and the Rheumatology Department at the Haywood Hospital for allowing us to collect data during routine clinics. This study was funded by an unrestricted educational research grant from Wyeth UK. The content of the article was not influenced in any way by employees of Wyeth.

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Authors and Affiliations

  1. Arthritis Research UK Primary Care Centre, Keele University, Staffordshire, ST5 5BG, UK

    E. L. Healey, K. L. Haywood, K. P. Jordan & J. C Packham

  2. Staffordshire Rheumatology Centre, Haywood Hospital, Burslem, Stoke-on-Trent, Staffordshire, ST6 7AG, UK

    E. L. Healey & J. C Packham

  3. Royal College of Nursing Research Institute (RCNRI), School of Health & Social Studies, University of Warwick, Coventry, CV4 7AL, UK

    K. L. Haywood

  4. Norwegian Knowledge Centre for the Health Services, PO Box 7004, St. Olavs plass, 0130, Oslo, Norway

    A. M Garratt

Authors
  1. E. L. Healey
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  2. K. L. Haywood
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  3. K. P. Jordan
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  4. A. M Garratt
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  5. J. C Packham
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Correspondence to K. L. Haywood.

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Healey, E.L., Haywood, K.L., Jordan, K.P. et al. Patients with well-established ankylosing spondylitis show limited deterioration in a ten-year prospective cohort study. Clin Rheumatol 32, 67–72 (2013). https://doi.org/10.1007/s10067-012-2092-3

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  • DOI: https://doi.org/10.1007/s10067-012-2092-3

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