Session Title: Epidemiology and Health Services II & III
Session Type: Abstract Submissions (ACR)
Ankylosing Spondylitis (AS) is a chronic, inflammatory form of arthritis that primarily affects the spine, which can cause significant pain and lead to bone ankylosis, deformities in the spine, and peripheral joint damage over time. Diminished quality of life, reduced productivity, and unemployment associated with AS present a significant burden to patients and society. The purpose of this study is to describe disease severity and morbidity in terms of patient-reported quality of life (QoL) and productivity loss and explore factors associated with productivity loss in patients with AS in Germany.
A multi-center observational study using 12-month retrospective chart review, with prospective paper-based questionnaires at the index visit and 3 months thereafter was conducted. Patients completed Short-form 36 (SF-36), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Work Productivity and Activity Impairment (WPAI). Physicians completed the Bath Ankylosing Spondylitis Metrology Index (BASMI) and current disease activity. Descriptive analyses of QoL, utility values derived from SF-36 domains, disease activity, and work productivity impairment were performed. Adjusted multivariate regression was used to explore the variables associated with productivity loss.
A total of 106 patients in 15 AS care centers across Germany were recruited. The majority of patients were men (75%), with a mean age of 46.5 ± 13.2 years and time since diagnosis of 14.6 ± 10 years. The main disease manifestation was inflammatory spinal pain (37%), followed by spinal deformities (27%) and hyperkyphosis (21%). Two-thirds of patients had co-morbidities including hypertension (28%), arthritis (25%), and psoriasis (15%). The main treatment was biological drugs in 72 patients (68%), followed by NSAIDs (53%) and Immunosuppressants (21%).
Physician evaluated the current disease activity with a mean of 2.8 ± 2.1. The mean of BASMI was 3.9 ± 1.8 at index visit, with the highest limitations in lumbar flexion at mean of 5.5 ± 2.7 and lateral spinal flexion at a mean of 4.5± 2.6.
The SF-36 summary means of physical health and mental health were 43.8 ± 8.9 and 46.9 ± 11.7. The lowest mean in the 8 domains was general health with 50.2 ± 19, followed by vitality with 52.7 ± 20.7 and bodily pain with 53.3 ± 24.4. The mean of SF-36 utility values was 0.7 ± 0.1.
Among 76 employed patients, 80% of the patients reported a mean of 2 ± 4 hours/week missed work due to AS at the index visit. Two-thirds of patients reported means of 26% of impairment while working and 31% of activity impairment due to AS. Limitation in physical functioning and BASDAI can explain 68% of productivity loss (Adjusted R2=0.6765, P<0.0001).
German AS patients had lower QoL and experienced substantial sick leave or impairment while working due to AS conditions. Productivity loss was significantly associated with limitation in physical functioning and BASDAI score.
« Back to 2013 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/disease-severity-quality-of-life-and-productivity-loss-among-patients-with-ankylosing-spondylitis-in-germany/