A Substantial Decrease in Work Productivity and Physical Health-Related Quality of Life in Chronic Back Pain of Recent Onset: Data from the SPACE-Cohort

A Roeterink¹, M de Hooge², R. van den Berg², H Dagfinrud³, M Turina⁴, M. van Oosterhout⁵, D. van der Heijde¹ and F van Gaalen², ¹Department of Rheumatology, Leiden University Medical Center, Leiden, Netherlands, ²Rheumatology, Leiden University Medical Center, Leiden, Netherlands, ³Oslo City Dept of Rheumat, Diakonhjemmet Hospital, Oslo, Norway, ⁴Department of Clinical Immunology and Rheumatology, Academic Medical Center/University of Amsterdam, Amsterdam, Netherlands, ⁵Groene Hartziekenhuis, Gouda, Netherlands

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: axial spondyloarthritis, back pain and quality of life, Work Disability

Session Information

Title: Spondyloarthropathies and Psoriatic Arthritis - Clinical Aspects and Treatment I

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Ankylosing spondylitis is associated with work productivity (WP) loss and a decreased health-related quality of life (HRQoL). Little is known about WP loss and HRQoL in early axial spondyloarthritis (SpA). Aim of the study was to determine the impact of chronic back pain (CBP) of recent onset on HRQoL and work productivity in young patients.

Methods:

The SPACE-cohort includes patients with CBP (≥3 months, ≤2 years, onset <45 years) in 5 European centers (n=345). Patients who met the ASAS axial SpA criteria were classified as axSpA (n=131). Patients with 1 SpA feature were defined as possible SpA (n=167), and those with no SpA features as no SpA (n=47). The 36-item Short-Form (SF-36) and Work Productivity and Activity Impairment (WPAI) surveys were used to assess HRQoL and WP. SF-36 physical (PCS) and mental component summary (MCS) scores were compared to the general population (a score of 50±10 SD represents the general population). Impact of disease on WP was defined as percentage of absenteeism, presenteeism and WP loss (which combines absenteeism and presenteeism) with greater scores indicating greater impairment.

Results:

304 patients completed the SF-36 and 230 the WPAI. Figure 1 shows a significant reduction of ≥2 SD in mean physical component scores (PCS) in all subgroups compared to the general population (25.9 in no SpA, 23.5 in possible SpA and 28.3 in axial SpA) . Mental components scores (MCS) were not significantly reduced in patients with CBP compared to the general population. Considerable absenteeism and presenteeism was present in all subgroups with CPB. Absenteeism was highest in no SpA and possible SpA (21.6% and 18.5%; compared to axSpA (10.3%) (p=0.10 and p=0.05, respectively),. Presenteeism was highest in no SpA and possible SpA (46.9% and 44.7%), compared to axSpA (34.7%). Total WPL was highest in no SpA and possible SpA (55.2% and 48.3%) compared to axSpA (37.5%),

Conclusion: Work productivity and physical health-related quality of life are already greatly reduced in young patients with chronic back pain of less than two years duration

Disclosure:

A. Roeterink,
None;

M. de Hooge,
None;

R. van den Berg,
None;

H. Dagfinrud,
None;

M. Turina,
None;

M. van Oosterhout,
None;

D. van der Heijde,
None;

F. van Gaalen,
None.

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