Background:When treating people with spondyloarthritis (SA), rheumatologists are focused on reducing disease activity based on activity measurement scores; but there may be other factors not directly captured by these tools, which impact on quality of life.Objectives:We aim to identify factors associated with poor quality of life in patients with spondyloarthritis.Methods:A cross-sectional study was performed in 100 patients with spondyloarthritis. Data on sociodemographic and disease characteristics were collected as well as specific scores: Visual analogue scale (VAS) for fatigue and pain, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score with CRP (ASDAS-CRP), Bath Ankylosing Spondylitis Functionnel Index (BASFI) and Bath Ankylosing Spondylitis Metrology Index (BASMI). EuroQol-5D (EQ5D) was used to assess health-related quality of life.Results:A total of 100 Patients were enrolled (73 men and 27 women); the mean age was 43.68 ± 10.3 years. Thirteen percent of patients had high level of education (> 12 years), 47% had BMI ≥ 25 and 47% were smoking. Sixty seven percent of patients had ankylosing spondylitis, 17% had rheumatism associated with inflammatory bowel disease and 16% had psoriatic rheumatism. The average disease duration was 12.24 ± 8.73 years. Mean age at onset was 33.2 ± 10 years. The average diagnostic delay was 2.41 ± 3 years. Sacroiliac pain has been noted in 69 patients, lumbar or cervical stiffness in 78 patients and peripheral joint involvement in 18 cases. Thirty one percent of patients had hip joint involvement and 49% had extra-articular manifestation. Fifty percent had inflammatory biological syndrome, 63% were treated with anti-TNFα and 58% needed symptomatic treatment regularly. The mean fatigue and pain VAS was respectively 5.58 ± 2.5 and 5.56 ± 2.9. The mean BASDAI was 4.4 ± 2.4, the average BASFI was 4.6 ± 2.7 and the average ASDAS-CRP was 2.77 ± 1.18. The mean BASMI was 4.4 ± 2.8. EQ5D questionnaire showed that: 37 patients had no problems with mobility, 61 had some problems and two had extreme problems; 39 patients had no problems with self-care, 55 had some problems and six had extreme problems; 35 patients had no problems with performing usual activities, 60 had some problems and five had extreme problems; 13 patients had no pain or discomfort, 61 had moderate pain or discomfort and 26 had important pain or discomfort; 42 patients had no anxiety or depression, 46 had moderate anxiety or depression and 12 had extreme anxiety or depression. The mean EQ5D score was 0.485 ± 0.378 [-0,448-1] and the mean general health EQ5D VAS was 59 ± 25% [7-100]. Poor quality of life was associated with smoking (p=0.03), physical inactivity (p<0.001), cervical and lumbar stiffness (p=0.001), peripheral joint involvement (p=0.006), inflammatory biological syndrome (p<0.001), need of symptomatic treatment (p<0.001), BASDAI > 4 (p<0.001), ASDAS > 2.1 (p<0.001), BASFI > 4 (p<0.001) and BASMI > 4 (p<0.001).Conclusion:Active disease and reduced physical function are the main causes of poor quality of life in patients with spondyloarthritis. Good disease management, smoking cessation and encouragement of physical activity can potentially improve patients’ quality of life.Disclosure of Interests:None declared.
Poor quality of life in indian ankylosing spondylitis patients