Determinants of health-related quality of life and global functioning and health in axSpA, pSpA, and PsA: results from the ASAS-PerSpA study

Helena Santos; Ana R Henriques; Pedro M Machado; Clementina Lopez-Medina; Maxime Dougados; Helena Canhão; Ana M Rodrigues; Fernando M Pimentel-Santos

doi:10.1093/rheumatology/kead503

Determinants of health-related quality of life and global functioning and health in axSpA, pSpA, and PsA: results from the ASAS-PerSpA study

Rheumatology (Oxford). 2023 Sep 21:kead503. doi: 10.1093/rheumatology/kead503. Online ahead of print.

Authors

Helena Santos¹, Ana R Henriques², Pedro M Machado³, Clementina Lopez-Medina^{4

5}, Maxime Dougados⁶, Helena Canhão⁷, Ana M Rodrigues⁸, Fernando M Pimentel-Santos⁹

Affiliations

¹ Nova Medical School, Instituto Português de Reumatologia, Lisbon, Portugal. EpiDoc Unit-CEDOC, Lisbon, Portugal.
² Nova Medical School, EpiDoc Unit-Comprehensive Health Research Center, Lisbon, Portugal.
³ Centre for Rheumatology and Department of Neuromuscular Diseases, University College of London, London, UK.
⁴ University Hospital Reina Sofia, Córdoba, Spain. IMIBIC, University of Córdoba, Córdoba, Spain.
⁵ COI: personal grants from UCB Pharma, Eli Lilly, Abbvie, Novartis and Janssen.
⁶ Rheumatology Department, Cochin Hospital, Paris, France.
⁷ Nova Medical School, Lisbon, Portugal. CHULC-Centro Hospitalar de Lisboa Central, EpiDoc Unit-Comprehensive Health Research Center, Lisbon, Portugal.
⁸ Nova Medical School, Lisbon, Portugal, Rheumatology Department Hospital dos Lusíadas, EpiDoc Unit-Comprehensive Health Research Center, Lisbon, Portugal.
⁹ NOVA Medical Research (NMR) - iNOVA4 Health, Rheumatic Diseases Lab-Nova Medical School, Universidade Nova de Lisboa, Lisbon, Portugal.

PMID: 37738594
DOI: 10.1093/rheumatology/kead503

Abstract

Objectives: We aim to identify determinants of health-related quality of life (HRQoL) and global functioning and health (GH) in axial spondyloarthritis (axSpA), peripheral spondyloarthritis (pSpA), and psoriatic arthritis (PsA).

Methods: ASAS-perSpA study data were analyzed. Models for the three patient groups were performed separately to explore factors associated with HRQoL and GH, assessed by EQ-5D and ASAS-HI, respectively.

Results: The analyses included 4185 patients: 2719 with axSpA, 433 with pSpA, and 1033 with PsA.In axSpA, disease activity (DA) (β=-0.061), physical function (β=-0.041), female sex (β=-0.019), and fibromyalgia (β=-0.068) were associated with worse HRQoL; age (β = 0.001) and university education (β = 0.014) with better HRQoL. In pSpA, DA (β=-0.04) and physical function (β=-0.054) were associated with worse HRQoL. In PsA, DA (β=-0.045), physical function (β=-0.053), axial disease (β=-0.041), and female sex (β=-0.028) were associated with worse HRQoL.In axSpA, DA (β = 0.889), physical function (β = 0.887), peripheral disease (β = 0.564), female sex (β = 0.812) and fibromyalgia (β = 1.639) were associated with worse GH; age (β=-0.013) and university education (β=-0.274) with better GH. In pSpA, physical function (β = 1.142), and female sex (β = 1.060) were associated with worse GH; university education (β=-0.611) with better GH. In PsA, DA (β = 0.703), physical function (β = 1.025), axial involvement (β = 0.659), female sex (β = 0.924), and fibromyalgia (β = 1.387) were associated with worse GH; age (β=-0.024) and university education (β=-0.856) with better GH.

Conclusions: DA and physical function are major HRQoL and GH determinants across spondyloarthritis types, and clinical characteristics and sociodemographic factors play an important role, highlighting the importance of a holistic approach for individual patients.

Keywords: ASAS-HI; EQ-5D; PerSpA; burden; determinants; global-health; outcomes; psoriatic arthritis; quality-of-life; spondyloarthritis.