Background/Purpose : Main objective: to describe health related quality of life (HRQoL), physical function (PF) and spinal mobility (SM) in patients with early axial Spondyloarthritis (axSpA). Second, to analyze the associations between HRQoL, PF and SM with disease activity and radiographic damage.

Methods : Baseline data from 259 patients fulfilling ASAS axSpA criteria from the Esperanza cohort were included. Validated versions of Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) and Bath Ankylosing Spondylitis Functional Index (BASFI) were used to evaluate HRQoL and PF. SM was assessed using Bath Ankylosing Spondylitis Metrology Index (BASMI). Disease activity was measured by means of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS), patient’s global and night back pain VAS and physician’ VAS, Maastricht AS Enthesitis Score (MASES) and CRP (mg/L). Radiographic damage was assessed through Bath Ankylosing Spondylitis Radiographic Index for the spine (BASRI-s) and sacroiliac joints scoring as in mNY criteria. Linear regression analyses were employed to evaluate the associations between disease activity and radiographic damage with HRQoL, PF and SM.

Results: 259 axSpA patients, 67% men, 39% AS. Mean ± SD disease duration 13.3±6.8 months; age 32.2±6.9 years; BASDAI 3.8±2.3; ASDAS 2.3±1.0; patient’s global and night back pain and physician VAS 4.2±2.7, 3.8±2.9 and 2.9±2.2; MASES 0.6±1.4; CRP 9.7±13.2 mg/L and BASRI-s 1.7±1.6.

Outcome values (Mean ± SD): ASQoL 5.9±4.8; BASFI 2.4±2.3 and BASMI1.4±1.3.

HRQoL and PF associations with all disease activity parameters (table 1) were observed in the univariable analysis, whereas HRQoL and PF associations with radiographic damage were weaker or not significant. Multivariable analysis only showed associations with disease activity for both outcomes (table 2).

Table 1: Linear regression univariable analysis adjusted for age and gender.

	ASQoL		BASFI		BASMI
	Std Beta	p value	Std Beta	p value	Std Beta	p value
CRP (mg/L)	0.272	p<0.01	0.300	p<0.01	0.187	p<0.01
ESR (mmHg)	0.113	p<0.1	0.186	p<0.01	0.074	NS
VAS (0-10) physician	0.558	p<0.01	0.616	p<0.01	0.285	p<0.01
VAS (0-10) patient	0.640	p<0.01	0.650	p<0.01	0.117	p<0.1
VAS (0-10) night back pain	0.597	p<0.01	0.593	p<0.01	0.106	p<0.1
BASDAI	0.645	p<0.01	0.691	p<0.01	0.167	p<0.01
ASDAS	0.564	p<0.01	0.608	p<0.01	0.193	p<0.01
MASES	0.239	p<0.01	0.239	p<0.01	0.052	NS
BASRI spine	0.149	p<0.05	0.154	p<0.05	0.322	p<0.01
Sacroiliitis xRay	0.078	NS	0.146	p<0.05	0.282	p<0.01

Table 2: Linear regression multivariable analysis adjusted for age and gender.

	ASQoL		BASFI		BASMI
	Std Beta	p value	Std Beta	p value	Std Beta	p value
CRP (mg/L)	0.107	0.07	0.126	0.02	0.032	0.7
VAS (0-10) physician	0.207	0.01	0.266	<0.001	0.246	0.02
VAS (0-10) night back pain	0.203	0.02	0.058	0.4	-0.085	0.4
BASDAI	0.336	<0.001	0.473	<0.001	0.043	0.7
MASES	0.096	0.1	0.078	0.2	–	–
BASRI spine	-0.011	0.9	-0.058	0.4	0.198	0.06
Sacroiliitis xRay	–	–	0.093	0.2	0.022	0.8

SM was mainly associated with radiographic damage (univariable), but only a trend was observed for this association in the multivariable analysis.

Conclusion : In patients with early axSpA, HRQoL and physical function are already impaired and primarily associated with disease activity.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/disease-activity-is-the-major-determinant-of-quality-of-life-and-physical-function-in-patients-with-early-axial-spondyloarthritis-results-from-the-esperanza-cohort/