AB0682 FUNCTIONAL IMPAIRMENT IN PATIENTS WITH AXIAL SPONDYLOARTHROPATHY IN A GERMAN COHORT: WORSE OUTCOMES AND WORSE QUALITY OF LIFE FOR FEMALE PATIENTS

Abstract

Background:Axial spondyloarthritis (AxSpA) may lead to significant structural damage resulting in marked impairment and disability. Historically, AxSpA has been thought to have a distinct male predominance regarding both, occurrence but also disease severity. However, it has recently been shown in international cohorts that women with AxSpA may have in fact an increased disease burden and worse outcome than their male counterparts.Objectives:The aim of this project was to analyse functional capacity in a German cohort of AxSpA patients and identify associated factors by comparing demographic data, clinical characteristics, disease activity and treatments.Methods:Analysis of a German University Hospital outpatient clinic cohort of 150 AxSpA patients. Questionnaire-based screening tools were used to assess disease activity, functional impairment and quality of life (BASDAI, FFbH, WHOQOL-BREF). Female and male patients were compared by independent samples two-tailed T tests for continuous variables as well as chi-squared test for categorical variables.Results:A German cohort of 150 AxSpA patients with 89 male and 61 female patients (mean age 49.3 years for males, 48.5 for females, p=0.77) was analyzed for functional capacity. Female patients had a significantly higher functional impairment in everyday life compared to males (p=0.013). After adjusting for age, linear regression showed female sex still to be significantly associated with functional impairment. Female patients rated their satisfaction with health as well as their physical and mental health-related quality of life significantly lower than male patients (p=0.015, respectively p=0.003 and p=0.002).There were no significant differences in disease duration, diagnostic delay or family history between male and female patients (p=0.731, p=0.971 and p=0.776). Women had a slightly higher disease activity (BASDAI 4.08 vs. 3.36), although just not statistically significant in our cohort (p=0.056). Female patients had more peripheral joint involvement (52.5% vs. 34.8%, p=0.032), as well as more enthesitis (31.1% vs. 16.9%, p=0.04), whereas there were no differences concerning eye involvement (p=0.51). Female patients were less likely to be HLA B27 positive (65.6 vs. 80.7%, p=0.04). and were less likely to be on anti-TNF treatment (p=0.032, respectively p=0.042).Conclusion:Also in our cohort female patients had a higher burden of disease as well as a worse patient reported outcome with worse quality of life and more self-reported functional impairment in everyday life. These data underline the importance of raising awareness for sex differences in disease presentation and suggest that female patients might require different treatment to achieve improved outcomes.Disclosure of Interests:None declared