Session Information
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Axial spondyloarthritis (axSpA) represents the whole clinical spectrum of ankylosing spondylitis (AS) including those at the non-radiographic (nr) stage of the disease. Although the disease burden associated with radiographic axSpA (classically known as AS) has been extensively studied, the burden associated with nr-axSpA is less well known.Our aim was to assess and compare the burden of radiographic and nr-axSpA.
Methods: This cross-sectional, observational study included consecutive AxSpA patients with varying disease severity, who attended our outpatient clinic between April 2014 and December 2014. During the visits, the following questionnaires were applied by trained health professionals:BASDAI, BASFI, HAQ-S, SF-36, ASQoL,Work Productivity and Activity Impairment (WPAI) and Work Productivity Survey (WPS).
Results:
A total of 381 AxSpA patients (279 AS) were analyzed. Nr-axSpA group, were younger (39.4 vs 43.1, p=0.007), more likely to be female (54% vs 33%, p<0.001), had a shorter disease duration (10.1 vs 16.0 years, p<0.001) and lower CRP (5.9 vs 13.2, p<0.001) and less common use of biologics (41.2% vs 26.5, p=0.008) despite higher BASDAI scores (Table). Broadly similar results were found for the other clinical outcome measures. Of all the axSpA patients, 58% were employed, with non-manual (25%), mixed (19%) and manual works (14%). Only 1.1% of the patients could not work due to arthritis. Patients with nr-axSpA reported more work productivity loss at workplace and at home over the last month, but the difference was significant only for household activities. Subgroup analysis showed that this difference was only found in females.
Conclusion: Patients with AS and nr-AxSpA demonstrate similar degree of disease burden and prodcutivity, with a greater impairment of household work in females. Low rate of inability to work due to arthritis in this population with a relatively high prevalence of anti-TNF use may be a reflection of the effectiveness of such therapies.
Table 1. Clinical variables related to disease burden in study participants. Data are presented as mean ± SD, unless otherwise stated
|
Variable |
AS (n=279) |
nr-axSpA (n=102) |
P value |
|
BASDAI (0–100) |
33.2±21.8 |
39.5±23.1 |
0.014 |
|
BASFI (0–100) |
30.5±24.1 |
29.4±24.6 |
0.711 |
|
HAQ-S |
0.7±0.6 |
0.8±0.6 |
0.606 |
|
SF36 PCS |
41.3±9.3 |
39.2±10 |
0.111 |
|
SF36 MCS |
46.1±10.5 |
43.3±11.4 |
0.060 |
|
ASqoL |
5.6±5.4 |
6.2±5.6 |
0.331 |
|
Work productivity and impairment index (refers to the last week) |
|||
|
Absenteeism (%)* |
8.7±25.5 |
12.3±30.3 |
0.374 |
|
Presenteeism (%)* |
33.8±25.0 |
37.1±25.9 |
0.401 |
|
Overall work impairment (%)* |
33.4±29.7 |
36.6±32.9 |
0.476 |
|
Daily activity impairment, (%) |
33.5±22.9 |
34.6±23.6 |
0.672 |
|
Work productivity survey (refers to the last month) |
|||
|
Days of work missed* |
1.4±4.6 |
3.0±6.6 |
0.090 |
|
Days with productivity at work reduced by ≥50%* |
2.6±6.3 |
4.6±8.2 |
0.090 |
|
Rate of SpA interference on work productivity* |
3.2±2.3 |
3.8±2.6 |
0.109 |
|
Days of household work missed |
2.5±5.6 |
4.8±7.6 |
0.010 |
|
Days with household productivity reduced by ≥50% |
3.1±2.1 |
3.6±2.3 |
0.048 |
|
Days with outside help |
2.7±6.5 |
2.8±5.9 |
0.815 |
|
Rate of SpA interference with household work productivity (0-10 ) |
3.1±2.1 |
3.7±2.3 |
0.052 |
*Assessed in employed patients only.
To cite this abstract in AMA style:
Kenar G, Cetin P, Can G, Capar S, Yarkan H, Sari I, Birlik M, Onen F, Akkoc N. The Burden of Axial Spondyloarthritis: A Comparison of the Radiographic and Non-Radiographic Groups [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/the-burden-of-axial-spondyloarthritis-a-comparison-of-the-radiographic-and-non-radiographic-groups/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-burden-of-axial-spondyloarthritis-a-comparison-of-the-radiographic-and-non-radiographic-groups/