Determining factors related to poor quality of life in patients with axial spondyloarthritis

results from the British Society for Rheumatology Biologics Register (BSRBR-AS)

Gary Macfarlane* (Corresponding Author), Ovidiu Rotariu, Gareth T Jones, Ejaz Mohammed Ishaq Pathan, Linda E Dean

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Objective To determine modifiable factors associated with poor quality of life (QoL) in patients with axial spondyloarthritis (axSpA).

Methods Analysis of data from the British Society for Rheumatology Biologics Register in Ankylosing Spondylitis (BSRBR-AS) and validation of a previous model using data from 1810 patients with axSpA recruited during 2012–2017. Data collected included clinical and patient-reported measures. QoL was assessed using the Ankylosing Spondylitis Quality of Life (ASQoL) measure. Linear regression models predicting ASQoL scores were used first to validate a previous model from a national study, to extend this with additional information available in BSRBR-AS and finally to identify a ‘de novo’ model from BSRBR-AS of which factors impact on poor QoL.

Results Four out of five factors included in a previous model of poor QoL in patients with axSpA were confirmed: Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index, fatigue and widespread pain, although the performance of the model was improved by the addition of measures of mood and sleep disturbance. In a de novo model in BSRBR-AS, there were six factors (other than disease activity and function) that predicted ASQoL: depression (β=0.16), sleep disturbance (β=0.08), activity impairment (β=0.04), fibromyalgia (Symptom Severity Scale (β=0.24) and Widespread Pain Index (β=0.10)) and tobacco smoking (β=0.66).

Conclusion This study confirms that poor QoL in patients with axSpA, in addition to high disease activity and poor function, is independently influenced by sleep disturbance, mood and widespread pain. These additional factors are not considered targets for treatment in current European League Against Rheumatism (EULAR) guidelines for managing the condition.
Original languageEnglish
JournalAnnals of the Rheumatic Diseases
Early online date29 Oct 2019
DOIs
Publication statusE-pub ahead of print - 29 Oct 2019

Fingerprint

Ankylosing Spondylitis
Rheumatology
Biological Products
Quality of Life
Sleep
Baths
Pain
Linear Models
Tobacco
Linear regression
Fibromyalgia
Fatigue of materials
Fatigue
Smoking
Guidelines
Depression

Keywords

  • disease register
  • fatigue
  • mood
  • quality of life, axial spondyloarthritis
  • sleep

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Allergy
  • Rheumatology
  • Immunology

Cite this

@article{cb4bf68653cd49b692e812361beaf6f2,
title = "Determining factors related to poor quality of life in patients with axial spondyloarthritis: results from the British Society for Rheumatology Biologics Register (BSRBR-AS)",
abstract = "Objective To determine modifiable factors associated with poor quality of life (QoL) in patients with axial spondyloarthritis (axSpA).Methods Analysis of data from the British Society for Rheumatology Biologics Register in Ankylosing Spondylitis (BSRBR-AS) and validation of a previous model using data from 1810 patients with axSpA recruited during 2012–2017. Data collected included clinical and patient-reported measures. QoL was assessed using the Ankylosing Spondylitis Quality of Life (ASQoL) measure. Linear regression models predicting ASQoL scores were used first to validate a previous model from a national study, to extend this with additional information available in BSRBR-AS and finally to identify a ‘de novo’ model from BSRBR-AS of which factors impact on poor QoL.Results Four out of five factors included in a previous model of poor QoL in patients with axSpA were confirmed: Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index, fatigue and widespread pain, although the performance of the model was improved by the addition of measures of mood and sleep disturbance. In a de novo model in BSRBR-AS, there were six factors (other than disease activity and function) that predicted ASQoL: depression (β=0.16), sleep disturbance (β=0.08), activity impairment (β=0.04), fibromyalgia (Symptom Severity Scale (β=0.24) and Widespread Pain Index (β=0.10)) and tobacco smoking (β=0.66).Conclusion This study confirms that poor QoL in patients with axSpA, in addition to high disease activity and poor function, is independently influenced by sleep disturbance, mood and widespread pain. These additional factors are not considered targets for treatment in current European League Against Rheumatism (EULAR) guidelines for managing the condition.",
keywords = "disease register, fatigue, mood, quality of life, axial spondyloarthritis, sleep",
author = "Gary Macfarlane and Ovidiu Rotariu and Jones, {Gareth T} and Pathan, {Ejaz Mohammed Ishaq} and Dean, {Linda E}",
note = "The BSRBR-AS is funded by the British Society for Rheumatology who have received funding for this from Pfizer, AbbVie and UCB. These companies receive advance copies of manuscripts for comments, but made none in relation to this manuscript.",
year = "2019",
month = "10",
day = "29",
doi = "10.1136/annrheumdis-2019-216143",
language = "English",
journal = "Annals of the Rheumatic Diseases",
issn = "0003-4967",
publisher = "BMJ Publishing Group",

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TY - JOUR

T1 - Determining factors related to poor quality of life in patients with axial spondyloarthritis

T2 - results from the British Society for Rheumatology Biologics Register (BSRBR-AS)

AU - Macfarlane, Gary

AU - Rotariu, Ovidiu

AU - Jones, Gareth T

AU - Pathan, Ejaz Mohammed Ishaq

AU - Dean, Linda E

N1 - The BSRBR-AS is funded by the British Society for Rheumatology who have received funding for this from Pfizer, AbbVie and UCB. These companies receive advance copies of manuscripts for comments, but made none in relation to this manuscript.

PY - 2019/10/29

Y1 - 2019/10/29

N2 - Objective To determine modifiable factors associated with poor quality of life (QoL) in patients with axial spondyloarthritis (axSpA).Methods Analysis of data from the British Society for Rheumatology Biologics Register in Ankylosing Spondylitis (BSRBR-AS) and validation of a previous model using data from 1810 patients with axSpA recruited during 2012–2017. Data collected included clinical and patient-reported measures. QoL was assessed using the Ankylosing Spondylitis Quality of Life (ASQoL) measure. Linear regression models predicting ASQoL scores were used first to validate a previous model from a national study, to extend this with additional information available in BSRBR-AS and finally to identify a ‘de novo’ model from BSRBR-AS of which factors impact on poor QoL.Results Four out of five factors included in a previous model of poor QoL in patients with axSpA were confirmed: Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index, fatigue and widespread pain, although the performance of the model was improved by the addition of measures of mood and sleep disturbance. In a de novo model in BSRBR-AS, there were six factors (other than disease activity and function) that predicted ASQoL: depression (β=0.16), sleep disturbance (β=0.08), activity impairment (β=0.04), fibromyalgia (Symptom Severity Scale (β=0.24) and Widespread Pain Index (β=0.10)) and tobacco smoking (β=0.66).Conclusion This study confirms that poor QoL in patients with axSpA, in addition to high disease activity and poor function, is independently influenced by sleep disturbance, mood and widespread pain. These additional factors are not considered targets for treatment in current European League Against Rheumatism (EULAR) guidelines for managing the condition.

AB - Objective To determine modifiable factors associated with poor quality of life (QoL) in patients with axial spondyloarthritis (axSpA).Methods Analysis of data from the British Society for Rheumatology Biologics Register in Ankylosing Spondylitis (BSRBR-AS) and validation of a previous model using data from 1810 patients with axSpA recruited during 2012–2017. Data collected included clinical and patient-reported measures. QoL was assessed using the Ankylosing Spondylitis Quality of Life (ASQoL) measure. Linear regression models predicting ASQoL scores were used first to validate a previous model from a national study, to extend this with additional information available in BSRBR-AS and finally to identify a ‘de novo’ model from BSRBR-AS of which factors impact on poor QoL.Results Four out of five factors included in a previous model of poor QoL in patients with axSpA were confirmed: Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index, fatigue and widespread pain, although the performance of the model was improved by the addition of measures of mood and sleep disturbance. In a de novo model in BSRBR-AS, there were six factors (other than disease activity and function) that predicted ASQoL: depression (β=0.16), sleep disturbance (β=0.08), activity impairment (β=0.04), fibromyalgia (Symptom Severity Scale (β=0.24) and Widespread Pain Index (β=0.10)) and tobacco smoking (β=0.66).Conclusion This study confirms that poor QoL in patients with axSpA, in addition to high disease activity and poor function, is independently influenced by sleep disturbance, mood and widespread pain. These additional factors are not considered targets for treatment in current European League Against Rheumatism (EULAR) guidelines for managing the condition.

KW - disease register

KW - fatigue

KW - mood

KW - quality of life, axial spondyloarthritis

KW - sleep

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U2 - 10.1136/annrheumdis-2019-216143

DO - 10.1136/annrheumdis-2019-216143

M3 - Article

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

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