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Evaluation of quality of life in patients with axial spondyloarthritis and its association with disease activity, functionality, mobility, and structural damage

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Abstract

To evaluate quality of life (QoL) in patients with axial spondyloarthritis (axSpA) and its association with disease activity, functionality, structural damage, and spinal mobility, using patient-reported outcomes. This was an observational, cross-sectional, and single-center study in which 100 consecutive patients with axSpA were included. We obtained from all patients’ sociodemographic data and values related to disease activity, functionality, structural damage, mobility, and quality of life. The Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) was considered as the primary outcome. Pearson r statistic, Student’s T test, and univariate and multivariate linear regressions were performed to relate ASQoL with the studied covariates. Mean ASQoL score in all patients was 4.02 ± 2.81, with statistically significant differences between male and female (3.61 ± 2.80 vs. 4.83 ± 2.70). Patients with high disease activity (measured by the ASAS-endorsed Disease Activity Score, ASDAS > 2.1) showed higher mean score in ASQoL than those with low disease activity (ASDAS ≤ 2.1) (3.21 ± 0.74 vs. 1.43 ± 0.43, p < 0.001). ASQoL presented a significant linear correlation with BASDAI, BASFI, and ASDAS (r > 0.60). However, disease duration was not significantly correlated with ASQoL. Finally, the 68.9% of the ASQoL variability (R2 = 0.689) was determined by BASDAI, BASFI, and mSASSS, presenting mSASSS a negative regression coefficient (− 0.035). In our study, the impairment of QoL was mainly associated with disease activity (BASDAI) and worsening of functionality (BASFI). However, there is an inverse relationship between the worsening of QoL and structural damage. In addition, disease duration does not seem to influence the patient’s welfare.

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References

  1. Rudwaleit M, Landewé R, van der Heidje D et al (2009) The development of assessment of spondyloarthritis international society classification criteria for axial spondyloarthritis (part I): classification of paper patients by expert opinion including uncertainty appraisal. Ann Rheum Dis 68:770–776 3

    Article  CAS  PubMed  Google Scholar 

  2. Dougados M, Baeten D (2011) Spondyloarthritis. Lancet 377:2127–2137

    Article  PubMed  Google Scholar 

  3. Khan M (1998) Ankylosing spondylitis: clinical aspects. In: Calin A, Taurog J (eds) The spondyloarthritides. Oxford University Press, Oxford

    Google Scholar 

  4. Wallis D, Haroon N, Ayearst R, Carty A, Inman RD (2013) Ankylosing spondylitis and nonradiographic axial spondyloarthritis: part of a common spectrum or distinct diseases? J Rheumatol 40:2038–2041

    Article  PubMed  Google Scholar 

  5. Robinson PC, Wordsworth BP, Reveille JD, Brown M (2013) Axial spondyloarthritis: a new disease entity, not necessarily early ankylosing spondylitis. Ann Rheum Dis 72:162–164

    Article  CAS  PubMed  Google Scholar 

  6. Van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis: a proposal for modification of the New York criteria. Arthritis Rheum 27:361–368

    Article  PubMed  Google Scholar 

  7. López-Medina C, Schiotis RE, Font-Ugalde P et al (2016) Assessment of fatigue in spondyloarthritis and its association with disease activity. J Rheumatol 43(4):751–757

    Article  PubMed  Google Scholar 

  8. Calvo-Gutiérrez J, Garrido-Castro JL, Gil-Cabezas J et al (2015) Is spinal mobility in patients with spondylitis determined by age, structural damage and inflammation? Arthritis Care Res 67(1):74–79

    Article  Google Scholar 

  9. Martindale J, Shukla R, Goodacre J (2015) The impact of ankylosing spondylitis/axial spondyloarthritis on work productivity. Best Pract Res Clin Rheumatol 29(3):512–523

    Article  PubMed  Google Scholar 

  10. Dougados M, d’Agostino MA, Benessiano J, Berenbaum F, Breban M, Claudepierre P, Combe B, Dargent-Molina P, Daurès JP, Fautrel B, Feydy A, Goupille P, Leblanc V, Logeart I, Pham T, Richette P, Roux C, Rudwaleit M, Saraux A, Treluyer JM, van der Heijde D, Wendling D (2011) The DESIR cohort: a 10-year follow-up of early inflammatory back pain in France: study design and baseline characteristics of the 708 recruited patients. Joint Bone Spine 78(6):598–603

    Article  PubMed  Google Scholar 

  11. Braun J, Sieper J (2002) Therapy of ankylosing spondylitis and other spondyloarthritides: established medical treatment, antiTNF-alpha therapy and other novel approaches. Arthritis Res 4:307–321

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Doward LC (2003) Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis 62(1):20–26

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Jones SD, Steiner A, Garrett SL, Calin A (1996) The Bath Ankylosing Spondylitis Patient Global Score (BAS-G). Br J Rheumatol 35(1):66–71

    Article  CAS  PubMed  Google Scholar 

  14. Baeten D, Sieper J, Braun J, Baraliakos X, Dougados M, Emery P, Deodhar A, Porter B, Martin R, Andersson M, Mpofu S, Richards HB, MEASURE 1 Study Group, MEASURE 2 Study Group (2015) Secukinumab, an interleukin-17A inhibitor, in ankylosing spondylitis. N Engl J Med 373:2534–2548

    Article  CAS  PubMed  Google Scholar 

  15. Martin-Mola E, Sieper J, Leirisalo-Repo M et al (2010) Sustained efficacy and safety, including patient-reported outcomes, with etanercept treatment over 5 years in patients with ankylosing spondylitis. Clin Exp Rheumatol 28:238–245

    CAS  PubMed  Google Scholar 

  16. Fernández-Carbadillo C, Navarro-Compán V, Castillo-Gallego C, Castro-Villegas MC, Collantes-Estévez E, de Miguel E et al (2017) Disease activity as a major determinant of quality of life and physical function in patients with early axial spondyloarthritis. Arthritis Care Res (Hoboken) 69(1):150–155

  17. Almodóvar R, Zarco P, Collantes E, González C, Mulero J, Fernández-Sueiro JL, Gratacós J, Torres-Alonso JC, Juanola X, Batlle E, Ariza R, Muñoz E (2009) Relationship between spinal mobility and disease activity, function, quality of life and radiology. A cross-sectional Spanish registry of spondyloarthropathies (REGISPONSER). Clin Exp Rheumatol 27:439–445

    PubMed  Google Scholar 

  18. Rudwaleit M, van der Heijde D, Landewé R, Listing J, Akkoc N, Brandt J (2009) The development of assessment of spondyloarthritis international society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis 68:777–783

    Article  CAS  PubMed  Google Scholar 

  19. Creemers MCW, Franssen MJAM, van’t Hof MA, Gribnau FWJ, van de Putte LBA, van Riel PLCM (2005) Assessment of outcome in ankylosing spondylitis: an extended radiographic scoring system. Ann Rheum Dis 64:127–129

    Article  CAS  PubMed  Google Scholar 

  20. Garrido-Castro JL, Medina Carnicer R, Schiottis R, Galisteo AM, Collantes-Estévez E, González-Navas C (2012) Assessment of spinal mobility in ankylosing spondylitis using a video-based motion capture system. Man Ther 17(5):422–426

    Article  PubMed  Google Scholar 

  21. Garrido-Castro JL, Escudero A, Medina-Carnicer R, Galisteo AM, Gonzalez-Navas C, Carmona L, Collantes-Estevez E (2014) Validation of a new objective index to measure spinal mobility: the University of Cordoba Ankylosing Spondylitis Metrology Index (UCOASMI). Rheumatol Int 34(3):401–406

    Article  PubMed  Google Scholar 

  22. Castro JL, Medina-Carnicer R, Galisteo AM (2006) Design and evaluation of a new three-dimensional motion capture system based on video. Gait Posture 24(1):126–129

    Article  PubMed  Google Scholar 

  23. Jenkinson TR, Mallorie PA, Whitelock HC, Kennedy LG, Garret SL, Calin A (1994) Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology Index (BASMI). J Rheumatol 21:1694–1698

    CAS  PubMed  Google Scholar 

  24. Calin A, Garrett S, Whitelock H, Kennedy LG, O’Hea J, Mallorie P et al (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of the bath ankylosing spondylitis functional index. J Rheumatol 21:2281–2285

    CAS  PubMed  Google Scholar 

  25. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin (1994) A new approach to defining disease status in ankylosing spondylitis: the bath ankylosing spondylitis disease activity index. J Rheumatol 21:2286–2291

    CAS  PubMed  Google Scholar 

  26. Lukas C, Landewé R, Sieper J, Dougados M, Davis J, Braun J, van der Linden S, van der Heijde D, Assessment of SpondyloArthritis international Society (2009) Development of an ASAS-endorsed disease activity score (ASDAS) in patients with ankylosing spondylitis. Ann Rheum Dis 68:18–24

    Article  CAS  PubMed  Google Scholar 

  27. Machado P, Landewé R, Lie E et al (2010) Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activity states and improvement scores. Ann Rheum Dis (In Press)

  28. Machado P, Landewé R, Braun J et al (2011) A stratified model for health outcomes in ankylosing spondylitis. Ann Rheum Dis 70:1758–1764

    Article  PubMed  Google Scholar 

  29. Jones SD, Koh WH, Steiner A, Garrett SL, Calin A (1996) Fatigue in ankylosing spondylitis: its prevalence and relationship to disease activity, sleep, and other factors. J Rheumatol 23:487–490

    CAS  PubMed  Google Scholar 

  30. Ward MM, Learch TJ, Gensler LS, Davis JC, Reveille JD, Weisman MH (2013) Regional radiographic damage and functional limitations in patients with ankylosing spondylitis: differences in early and late disease. Arthritis Care Res 65(2):257–265

    Article  Google Scholar 

  31. Ogzul A, Peker F, Taskaynatan MA, Tan AK, Dincer K, Kalyon TA (2006) Effect of ankylosing spondylitis on health-related quality of life and different aspects of social life in young patients. Clin Rheumatol 25(2):168–174

    Article  Google Scholar 

  32. de Carvalho HM, Bortoluzzo AB, Gonçalves CR et al (2012) Gender characterization in a large series of Brazilian patients with spondyloarthritis. Clin Rheumatol 31:687–695

    Article  PubMed  Google Scholar 

  33. Webers C, Essers I, Ramiro S, Stolwijk C, Landewé R, van der Heijde D, van den Bosch F, Dougados M, van Tubergen A (2016) Gender-attributable differences in outcome of ankylosing spondylitis: long-term results from the outcome in ankylosing spondylitis international study. Rheumatology 55(3):419–428

    PubMed  Google Scholar 

  34. Dagfinrud H, Vollestad NK, Loge JH, Kvien TK, Mengshoel AM (2005) Fatigue in patients with ankylosing spondylitis: a comparison with the general population and associations with clinical and self-reported measures. Arthritis Rheum 53:5–11

    Article  PubMed  Google Scholar 

  35. Salaffi F, De Angelis R, Carotti M, Gutierrez M, Sarzi-Puttini P, Atzeni F (2014 Aug) Fibromyalgia in patients with axial spondyloarthritis: epidemiological profile and effect on measures of disease activity. Rheumatol Int 34(8):1103–1110

    PubMed  Google Scholar 

Download references

Acknowledgments

The authors wish to thank all patients who participated in the study.

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Authors and Affiliations

  1. Maimónides Institute for Research in Biomedicine of Cordoba (IMIBIC), Avda. Menendez Pidal, s/n, 14004, Córdoba, Spain

    Clementina López-Medina, Juan L. Garrido-Castro, Cristina González-Navas, Jerusalem Calvo-Gutiérrez, M. Carmen Castro-Villegas, Rafaela Ortega-Castro, Alejandro Escudero-Contreras, Pilar Font-Ugalde & Eduardo Collantes-Estévez

  2. Rheumatology Department, Reina Sofia University Hospital, 14004, Córdoba, Spain

    Clementina López-Medina, Juan L. Garrido-Castro, Cristina González-Navas, Jerusalem Calvo-Gutiérrez, M. Carmen Castro-Villegas, Rafaela Ortega-Castro, Alejandro Escudero-Contreras, Pilar Font-Ugalde & Eduardo Collantes-Estévez

  3. Córdoba University (UCO), 14004, Córdoba, Spain

    Clementina López-Medina, Juan L. Garrido-Castro, Juan Castro-Jiménez, Jerusalem Calvo-Gutiérrez, M. Carmen Castro-Villegas, Rafaela Ortega-Castro, Alejandro Escudero-Contreras, Pilar Font-Ugalde & Eduardo Collantes-Estévez

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  1. Clementina López-Medina
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  2. Juan L. Garrido-Castro
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  3. Juan Castro-Jiménez
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  4. Cristina González-Navas
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  5. Jerusalem Calvo-Gutiérrez
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  8. Alejandro Escudero-Contreras
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  9. Pilar Font-Ugalde
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  10. Eduardo Collantes-Estévez
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Correspondence to Clementina López-Medina.

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López-Medina, C., Garrido-Castro, J.L., Castro-Jiménez, J. et al. Evaluation of quality of life in patients with axial spondyloarthritis and its association with disease activity, functionality, mobility, and structural damage. Clin Rheumatol 37, 1581–1588 (2018). https://doi.org/10.1007/s10067-018-4112-4

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  • DOI: https://doi.org/10.1007/s10067-018-4112-4

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