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BMC Musculoskeletal Disorders

, 18:328

Clinical rheumatology and osteoporosis

Abstract

BackgroundAxial spondyloarthritis ax-SpA is a chronic inflammatory disease of the spine causing pain, stiffness, loss in physical function, and fatigue. Therefore, the physical and psychological burden of having this chronic disease can reduce the quality of life. We aimed to explore the relationship between demographic- and disease-related variables and health-related quality of life HRQoL in patients with ax-SpA.

MethodsDemographic- and disease-related, HRQoL-related and treatment data were collected. Disease measures included the Bath Ankylosing Spondylitis Disease Activity Index BASDAI, the BAS Functional Index BASFI, the BAS Global BAS-G score, the Maastricht Ankylosing Spondylitis Enthesitis Score MASES, the Health Assessment Questionnaire HAQ and co-morbidity. HRQoL was assessed using the SF-36 and the utility measures SF-6D and 15D. Variables associated with HRQoL were identified in unadjusted and adjusted analyses.

ResultsWe examined 380 patients with ax-SpA 67% men with a mean age of 46 years. Among them, 86% reported exercising >1 h per week. Mean values were as follows: BASDAI, 3.17; MASES, 3.19; BASFI, 2.71; BAS-G. 3.88; and HAQ, 0.56. The percentage of current users of NSAIDs was 44%, and of DMARDs 23%. In multivariate analyses, exercising 1–3 h per week B = 2.73, p = 0.022 and exercising >3 h per week B = 2.71, p = 0.020, lower HAQ scores B = −4.61, p = 0.001, lower BASFI scores B = −1.05, p = 0.010 and lower BAS-G scores B = −0.91, p = 0.001 were independently associated with higher SF-36-PCS scores, whereas modest alcohol consumption B = 4.63, p = 0.018 and a lower BAS-G score B = −1.73, p < 0.001 were independently associated with higher SF-36-MCS scores. Exercising 1–3 h per week B = 0.032, p = 0.004 and exercising >3 h per week B = 0.036, p = 0.001, lower HAQ scores B = −0.051, p < 0.001, lower BAS-G scores B = −0.010, p < 0.001 and co-morbidity B = −0.014, p = 0.004 were independently associated with higher 15D scores. Finally, exercising 1–3 h per week B = 0.045, p = 0.001 and exercising > 3 h per week B = 0.053, p < 0.001, lower HAQ scores B = −0.054, p = 0.001 and lower BAS-G scores B = −0.020, p < 0.001 were associated with higher SF-6D scores.

ConclusionsIn patients with ax-SpA, a low level of physical activity, impaired physical function and impaired general well-being were independently and consistently associated with a decreased HRQoL across all applied measures.

KeywordsAxial spondyloarthritis Health-related quality of life Utility measures Exercise Targeted medications AbbreviationsASAnkylosing spondylitis

ax-SpAaxial spondyloarthritis

BASDAIBath Ankylosing Spondylitis Activity Index

BASFIBath Ankylosing Spondylitis Functional Index

BAS-GBath Ankylosing Spondylitis Patient Global Score

BMIBody mass index

CRPC-reactive protein

DMARDsDisease-modifying anti-rheumatic drugs

GLMGeneral linear model

HAQHealth Assessment Questionnaire

HRQoLHealth-related quality of life

MASESMaastricht Ankylosing Spondylitis Enthesitis Score

MCSMental component summary

MHHMartina Hansens Hospital

NSAIDsNon-steroidal anti-inflammatory drugs

PCSPhysical component summary

QALYsQuality-adjusted life years

REKNorwegian Regional Committee for Medical Research Ethics

SSHFSørlandet Hospital

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Autor: Gudrun Rohde - Kari Hansen Berg - Anne Prøven - Glenn Haugeberg

Fuente: https://link.springer.com/



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