FRI0184 High prevalence of hidradenitis suppurativa, especially in female axial spondyloarthritis patients with high disease activity and poor quality of life

Abstract Background/Aims Axial spondyloarthritis (axSpA) is a chronic rheumatic condition, characterised by inflammatory back pain - often associated with impaired function and mobility, sleep disturbance, fatigue, and reduced quality of life. Despite the vast advances in pharmacological treatments for axSpA over the last few decades, physical activity and rehabilitation remain vital for effective disease management. At the Royal National Hospital for Rheumatic Diseases in Bath (RNHRD), the 2-week inpatient axSpA rehabilitation programme has been integral to axSpA care since the 1970’s. Prior research has demonstrated significant short-term improvements in spinal mobility (BASMI), function (BASFI) and disease activity (BASDAI) following course attendance. However, the long-term outcomes are yet to be evaluated in this unique cohort. Methods Since the early 1990’s, clinical measures of spinal mobility, function and disease activity have been routinely collected at the RNHRD at all clinical appointments through administration of the BASMI, BASFI and BASDAI, respectively. Dates of attending the axSpA course and standard clinical and treatment follow-up data were also collected. Multiple linear regression models were used to investigate the impact of course attendance on final reported BASMI, BASDAI and BASFI scores (final score=most recent). Length of follow-up was defined as time between first and last recorded BASMI. Results Of the 203 patients within the Bath SPARC200 cohort, 77.8% (158/203) had attended at least one rehabilitation course throughout follow-up. 70.0% (140/203) of patients were male. The mean duration of follow-up was 13.5 years (range 0-35 years); 28.1% (57/203) of individuals with 20+ years of follow-up. Course attendance (yes versus no) significantly reduced final BASMI score by 0.84 (p = 0.001, 95%CI -1.31 to -0.37) and final BASDAI score by 0.74 (p = 0.018, 95%CI -1.34 to -0.13). Although course attendance reduced final BASFI by 0.45 (95%CI -1.17 to 0.28), this relationship did not reach significance (p = 0.225). Whilst minimally clinically important difference (MCID) is, to our knowledge, yet to be defined for BASMI, MCIDs were achieved long-term for both BASDAI and BASFI - defined by van der Heijde and colleagues in 2016 as 0.7 and 0.4 for BASDAI and BASFI, respectively. Conclusion These results provide novel evidence to support the integral role of education, physical activity and rehabilitation in the management of axSpA. Future work should investigate additional outcomes of critical importance to patients and clinicians, such as fatigue, quality of life and work productivity. Furthermore, a greater understanding of the factors that confound these outcomes may provide insights into those patients who may most benefit from attending a 2-week rehabilitation course. In addition to facilitating identification of those patients who may require additional clinical support. Disclosure R. Barnett: None. A. McGrogan: None. M. Young: None. C. Cavill: None. M. Freeth: None. R. Sengupta: Honoraria; Biogen, Celgene, AbbVie, Novartis, MSD. Grants/research support; Novartis, UCB.

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Early detection of high disease activity in juvenile idiopathic arthritis by sequential monitoring of patients' health‐related quality of life scores

Biometrical Journal ◽

10.1002/bimj.201900127 ◽

2020 ◽

Vol 62 (5) ◽

pp. 1343-1356

Author(s):

Lu You ◽

Andrew Qiu ◽

Bin Huang ◽

Peihua Qiu

Keyword(s):

Quality Of Life ◽

Juvenile Idiopathic Arthritis ◽

Early Detection ◽

Disease Activity ◽

High Disease Activity ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Uncovering the heterogeneity of disease impact in axial spondyloarthritis: bivariate trajectories of disease activity and quality of life

RMD Open ◽

10.1136/rmdopen-2018-000755 ◽

2018 ◽

Vol 4 (2) ◽

pp. e000755 ◽

Cited By ~ 3

Author(s):

Maike Imkamp ◽

Valéria Lima Passos ◽

Annelies Boonen ◽

Suzanne Arends ◽

Maxime Dougados ◽

...

Keyword(s):

Quality Of Life ◽

Disease Activity ◽

Axial Spondyloarthritis ◽

International Study ◽

High Impact ◽

Symptom Duration ◽

Related Quality ◽

Health Related ◽

Insight Into

ObjectiveThe goal of managing axial spondyloarthritis (axSpA) is to improve and maintain patients’ health-related quality of life (HRQoL), mainly through targeting towards low disease activity. Here, we aim to gain insight into the joint evolution of HRQoL and disease activity by identifying and characterising latent subgroups of patients with longstanding disease displaying similar trajectories throughout 8 years of follow-up.MethodsData from Outcome in Ankylosing Spondylitis (AS) International Study (n=161) and Groningen Leeuwarden AS cohort (n=264) were used. Biennially, HRQoL was assessed by AS Quality of Life (ASQoL) and disease activity by AS Disease Activity Score—C reactive protein (ASDAS-CRP). Bivariate trajectories of these outcomes were estimated by group-based trajectory modelling. Next, trajectories were profiled by comparing the latent groups with respect to baseline factors using analysis of variance and χ² test.ResultsFive bivariate trajectories were distinguished, in which ASQoL and ASDAS-CRP were tightly linked: (t1) low impact of disease; (t2) moderate impact; (t3) high impact with major improvement; (t4) high impact with some improvement; (t5) very high impact. Profiling revealed, for example, that (t1) was characterised by male gender and Human Leucocyte Antigen B27 positivity; (t3) by younger age, shorter symptom duration and biological intake and (t5) by the highest proportion of females.ConclusionsWe identified five bivariate trajectories of HRQoL and disease activity demonstrating a clear mutual relationship. The profiles revealed that both individual-related and disease-related features define the type of disease course in respect to HRQoL and disease activity in axSpA. This may provide clinicians insight into the differences among patients and help in the management of the disease.

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Sexual Quality of Life in Patients with Axial Spondyloarthritis in the Biologic Treatment Era

The Journal of Rheumatology ◽

10.3899/jrheum.180413 ◽

2019 ◽

Vol 46 (9) ◽

pp. 1075-1083 ◽

Cited By ~ 3

Author(s):

Kari Hansen Berg ◽

Gudrun Elin Rohde ◽

Anne Prøven ◽

Esben Esther Pirelli Benestad ◽

Monika Østensen ◽

...

Keyword(s):

Quality Of Life ◽

Ankylosing Spondylitis ◽

Disease Activity ◽

Axial Spondyloarthritis ◽

Activity Index ◽

Statistical Tests ◽

Linear Regression Analysis ◽

Biologic Treatment ◽

Sexual Quality Of Life

Objective.To examine the relationship between demographics, disease-related variables, treatment, and sexual quality of life (SQOL) in men and women with axial spondyloarthritis (axSpA).Methods.AxSpA patients were consecutively recruited from 2 rheumatology outpatient clinics in southern Norway. A broad spectrum of demographics, disease, treatment, and QOL data were systematically collected. SQOL was assessed using the SQOL-Female (SQOL-F) questionnaire (score range 18–108). Appropriate statistical tests were applied for group comparison, and the association between independent variables and SQOL-F was examined using multiple linear regression analysis.Results.A total of 360 (240 men, 120 women) axSpA patients with mean age 45.5 years and disease duration 13.9 years were included. Seventy-eight percent were married/cohabiting, 26.7% were current smokers, 71.0% were employed, 86.0% performed > 1-h exercise per week, and 88.0% were HLA-B27–positive. Mean (SD) values for disease measures were C-reactive protein (CRP) 8.5 (12.1) mg/l, Bath Ankylosing Spondylitis Disease Activity Index 3.1 (2.1), Bath Ankylosing Spondylitis Global Score (BAS-G) 3.8 (2.5), Bath Ankylosing Spondylitis Functional Index 2.7 (2.2), and Health Assessment Questionnaire 0.6 (0.5). The proportion of patients using nonsteroidal antiinflammatory drugs was 44.0%, synthetic disease-modifying antirheumatic drugs (DMARD) 5.0%, and biologic DMARD 24.0%. Mean (SD) total sum score for SQOL was 76.6 (11.3). In multivariate analysis, female sex, increased body mass index, measures reflecting disease activity (BAS-G and CRP), and current biologic treatment were independently associated with a lower SQOL.Conclusion.Our data suggest that inflammation in patients with axSpA even in the biologic treatment era reduces SQOL.

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FRI0321 UTILITY OF THE ASAS HEALTH INDEX QUESTIONNAIRE AS A TOOL FOR HEALTH ASSESSMENT IN PATIENTS WITH SPONDYLOARTHRITIS AND ITS ASSOCIATION WITH DISEASE ACTIVITY, FUNCTIONALITY, MOBILITY, AND STRUCTURAL DAMAGE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5640 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 752.1-752

Author(s):

M. Á. Puche Larrubia ◽

C. López-Medina ◽

M. D. C. Castro Villegas ◽

R. Ortega Castro ◽

M. Ladehesa Pineda ◽

...

Keyword(s):

Quality Of Life ◽

Linear Regression ◽

Disease Activity ◽

Linear Correlation ◽

Structural Damage ◽

High Disease Activity ◽

Continuous Variables ◽

Health Index ◽

The Impact

Background:The ASAS Health Index (ASAS-HI) questionnaire, a tool that measures the impact of the disease on the health in patients with Spondyloarthritis (SpA), has been recently validated. However, there are still no studies evaluating the utility of this questionnaire in daily clinical practice.Objectives:The objective of this study is to evaluate the association of ASAS-HI with disease activity, functionality, mobility, and structural damage in patients with SpA.Methods:This is an observational, cross-sectional and single-center study in which 126 consecutive patients with SpA were included. Sociodemographic data, scores related to disease activity (BASDAI and ASDAS), functionality (BASFI), structural damage (cervical, lumbar and total mSASSS), mobility (BASMI and UCOASMI), quality of life (ASAS-HI) and the presence of concomitant fibromyalgia (evaluated with the FIRST questionnaire) were obtained from all patients. The ASAS-HI questionnaire was considered as the main outcome (scale from 0 to 17). Pearson’s correlation coefficient was used to evaluate the association of the different continuous variables with each other. Student’s t-test was used to compare the ASAS-HI between different subgroups of patients (men vs. women, ASDAS>2,1 vs. ASDAS≤2,1 and fibromyalgia + vs. fibromyalgia-). Finally, a multivariate linear regression was performed to determine which factors explain the variability of ASAS-HI in these patientsResults:Among the 126 patients included, 83 (65.9%) were men, with a mean age of 45.1±12.3 years and a mean disease duration of 18.7±14.5 years. The mean ASAS-HI score in all patients was 4.7±4.0, showing a “strong” positive linear correlation (r>0.60) with BASDAI and BASFI, and “moderate” positive (r=0.40 to 0.60) with Global VAS and ASDAS (Figure 1). Patients with fibromyalgia showed a significantly higher ASAS-HI score compared with patients without fibromyalgia (9.5±3.2 vs 3.7±3.4, respectively). In addition, patients with high disease activity (ASDAS>2,1) showed a higher mean score in ASAS-HI compared with those with low activity (ASDAS≤2,1) (5.8 ± 3.8 vs 2.0 ± 2.4, p<0,001).Figure 1.Simple linear correlation (Pearson’s r) between the different variables studied.Finally, multiple linear regression showed that 57,4% (R2=0,574) of the ASAS-HI variability is explained by the presence of concomitant fibromyalgia (β = 2.23, 95%IC 0.73 to 3.80, p=0.004), BASDAI (β = 0.62, 95%IC 0.25 to 0.97, p=0.001) and BASFI (β = 0.57, 95%IC 0.26 to 0.88, p=0.001).Conclusion:In our study, the impairment of the quality of life in patients with SpA was mainly associated with a high disease activity (BASDAI), worsening functionality (BASFI) and with the presence of concomitant fibromyalgia. Neither mSASSS nor UCOASMI was associated with a change in ASAS-HI; thus, in our patients neither structural damage nor mobility seem to influence the quality of life. In a patient with a high ASAS-HI we must evaluate the presence of concomitant fibromyalgia.Acknowledgments:The authors wish to thank all patients who participated in the study.Disclosure of Interests:María Ángeles Puche Larrubia: None declared, Clementina López-Medina: None declared, María del Carmen Castro Villegas: None declared, Rafaela Ortega Castro: None declared, MLourdes Ladehesa Pineda: None declared, Pérez Sánchez Laura: None declared, Gómez García Ignacio: None declared, José Miguel Sequí-Sabater: None declared, Maria del Carmen Abalos-Aguilera: None declared, Inmaculada Concepcion Aranda-Valera: None declared, Garrido Castro Juan Luis: None declared, Alejandro Escudero Contreras Grant/research support from: ROCHE and Pfizer, Speakers bureau: ROCHE, Lilly, Bristol and Celgene., Eduardo Collantes-Estevez: None declared

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