Session Information
Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: There is a lack of data on the quality of life (QoL) in patients (pts) with active peripheral spondyloarthritis (pSpA). The purpose of this study was to assess the QoL in pts with pSpA, and compare it to the QoL across other rheumatic diseases.
Methods: Data for this analysis originated from the following five trials of adalimumab versus placebo for various rheumatic diseases: ABILITY-2 for pSpA; ABILITY-1 for non-radiographic axial SpA (nr-axSpA); ATLAS for ankylosing spondylitis (AS); DE019 for rheumatoid arthritis (RA), and ADEPT for psoriatic arthritis (PsA). In each dataset, the QoL at baseline was measured by the Short Form 36 (SF-36) mental component summary (MCS) and physical component summary (PCS). Differences from the norms for an age-and gender- matched healthy control population at baseline were calculated for each rheumatic disease. In order to assess the influence of disease activity and disease duration on MCS and PCS, patients were stratified into tertiles by disease activity or disease duration. The difference in MCS and PCS and the 95% CI for the extreme tertiles (lower vs higher) was compared to that for an age- and gender-matched normal population. Lower vs. higher disease activity was defined as: Bath Ankylosing Spondylitis Disease Activity Score (BASDAI) ≤4.8 or >6.5 for pSpA; ≤6.0 and >7.1 for nr-axSpA; ≤5.6 and >7.1 for AS; 28-joint count disease activity score based on C-reactive protein [DAS28(CRP)] ≤5.3 and >6.1, for RA; Patient’s global assessment (PtGA) ≤39 and >60 for PsA. Shorter vs. longer disease duration was defined as: ≤2.6 or >3.4 years (yrs) for pSpA; ≤0.5 or >2.3 yrs for nr-axSpA; ≤5.2 or >13.4 yrs for AS; ≤5 or >12.9 yrs for RA; ≤4.2 or >11.2 yrs for PsA.
Results: Across the five rheumatic diseases, the differences in SF-36 MCS and PCS compared to the norms for an age- and gender-matched population were similar (table). However, the observed difference from the norm was greater for the PCS than for the MCS indicating a greater impact on physical function. For each disease, higher disease activity, but not longer disease duration was associated with a significantly greater difference in PCS and MCS compared to the norms.
Conclusion: Patients with pSpA suffer from a poor quality of life, to a similar extent compared with the other rheumatic diseases included here. Results indicate that current disease activity and not disease duration contributes to this impairment of physical and mental health.
Table: Mean Difference compared to age- and gender matched population norms for SF-36 PCS and MCS at baseline, mean (95% CI) |
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nr-axSpA (ABILITY-1), N=185 |
pSpA (ABILITY-2), N=165 |
AS (ATLAS), N=311 |
PsA (ADEPT), N=310 |
RA- (DE019), N=605 |
PCS |
-18.3 (-19.5, -17.2) |
-16.7 (-18.0, -15.5) |
-18.8 (-19.6, -17.9) |
16.4 (-17.5, -15.3) |
-15.9 (-16.6, -15.2) |
MCS |
-6.6 (-8.4, -4.9) |
-5.9 (-7.7, -4.1) |
-6.4 (-7.7, -5.1) |
-3.2 (-4.5, -2.0) |
-2.8 (-3.8, -1.9) |
SF-36 PCS/MCS in patients with lower vs. higher disease activity |
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PCS-lower |
-15.2 (-17.0, -13.3)* |
-13.13 (-15.5,-10.7)* |
-15.4 (-16.9, -13.8)* |
-10.0 (-11.7, -8.2)* |
-12.0 (-13.3, -10.8)* |
PCS-higher |
-21.4 (-23.5, -19.4)* |
-18.9 (-21.0, -16.9)* |
-21.8 (-23.3, -20.4)* |
-23.0 (-24.6, -21.3)* |
-18.9 (-19.9, -17.8)* |
MCS-lower |
-3.1 (-6.1,-0.2)* |
-0.03 (-2.7, 2.6)* |
-3.7 (-5.7, -1.6)* |
0.6 (-1.4, 2.6)* |
0.5 (-1.0, 2.1)* |
MCS-higher |
-11.2 (-14.1, -8.2)* |
-9.6 (-12.2, -7.1)* |
-10.5 (-13.0, -7.9)* |
-7.1 (-9.4, -4.7)* |
-6.7 (-8.3, -5.0)* |
SF-36 PCS/MCS in patients with shorter vs. longer disease duration |
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PCS-shorter |
-19.6 (-21.6, -17.5) |
-18.2 (-20.6, -15.9) |
-19.5 (-21.1, -17.9) |
-14.3 (-16.1, -12.5) |
-16.0 (-17.2 -14.8) |
PCS- longer |
-17.9(-20.0, -15.9) |
-15.5 (-18.0, -13.1) |
-18.0 (-19.6, -16.5) |
-16.8 ( -18.9, -14.6) |
-15.8 (-16.9, -14.6) |
MCS-shorter |
-7.4 (-10.6, -4.3) |
-5.9 (-9.3, -2.4) |
-7.6 (-9.8, -5.3) |
-1.6 (-3.7,0.5) |
-3.3 (-4.8, -1.8) |
MCS- longer |
-4.8 (-8.0, -1.7) |
-5.1 (-8.3, -1.9) |
-7.2 (-9.5, -5.0) |
-3.5 (-5.9, -1.2) |
-2.6 (-4.3, -0.9) |
*p<0.001 for difference between groups with lower vs. higher disease activity. |
To cite this abstract in AMA style:
Mease PJ, van der Heijde D, Mittal M, Joshi AD, Xu Y, Pangan AL, Song IH. Quality of Life in Patients with Active Peripheral Spa Is Similarly Impaired As in Other Rheumatic Diseases and Influenced By Disease Activity but Not Disease Duration [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/quality-of-life-in-patients-with-active-peripheral-spa-is-similarly-impaired-as-in-other-rheumatic-diseases-and-influenced-by-disease-activity-but-not-disease-duration/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/quality-of-life-in-patients-with-active-peripheral-spa-is-similarly-impaired-as-in-other-rheumatic-diseases-and-influenced-by-disease-activity-but-not-disease-duration/