POS0147 DETERMINANTS OF GENERAL HEALTH AND HEALTH RELATED QUALITY OF LIFE IN AXIAL SPONDYLOARTHRITIS, PERIPHERAL SPONDYLOARTHRITIS AND PSORIATIC ARTHRITIS: RESULTS FROM THE ASAS-PerSpA STUDY

Abstract

BackgroundAxial Spondyloarthritis (axSpA), peripheral Spondyloarhritis (pSpA) and Psoriatic arthritis (PsA) are different types of SpA, with large heterogeneity in clinical manifestations. It is crucial to understand which are the determinants of health-related quality of life (HRQoL) and general health (GH, global functioning and health) in axSpA, pSpA and PsA, which can lead to differential approaches and interventions, to attain better outcomes.ObjectivesThis study aims to identify and compare determinants of HRQoL and GH in axSpA, pSpA and PsA, using data from the PerSpA study.MethodsData from the ASAS-PerSpA study, a cross-sectional and multicenter study with 24 participating countries, was used. Patients with either axSpA, pSpA or PsA were enrolled. Sociodemographic, lifestyle, anthropometric, and clinical characteristics were collected. Univariable and multivariable regression models for the three groups were performed separately, to explore factors associated with HRQoL, assessed by EuroQoL-5 Dimensions 3 level (EQ-5D), and similar analysis was performed for GH, assessed by the Assessment of SpondyloArthritis international Society Health Index (ASAS-HI).Results4185 patients were included in the analyses. For the final models, only patients with complete data were included (results summarized in Table 1). Regarding HRQoL, worse HRQoL in axSpA was associated with female gender, fibromyalgia (FM), peripheral disease (PD), worse function and higher disease activity (DA) and patient’s global assessment (PGA), in pSpA with worse function, higher DA and higher non-steroidal anti-inflammatory drugs intake score (NSAIDs-IS), and in PsA with female gender, axial involvement, worse function, higher DA and glucocorticoid therapy. On the contrary, better HRQoL was associated in axSpA with a history of uveitis, in pSpA with older age (with a trend in axSpA and PsA, but not statistically significant) and in PsA with biologic therapy. Regarding GH, in axSpA, worse GH was associated with female gender, FM, PD, worse function and higher DA and PGA, in pSpA, with female gender, inflammatory bowel disease, worse function, treatment with conventional synthetic disease-modifying anti-rheumatic drug and higher NSAIDs-IS, in PsA with female gender, alcohol intake, FM, axial involvement, worse function and higher DA. On the contrary, better GH was associated in axSpA with university education (UE), higher BMI and higher NSAIDs-IS, in pSpA with UE, and in PsA with older age and UE.Table 1.Factors associated with HRQoL and GH stratified by diagnostic category (summarized)EQ-5DASAS-HIaxSpAn= 2698 R2=0.548pSpAn= 418R2=0.520PsAn= 1017R2=0.551axSpAn= 2700R2=0.539pSpAn= 418R2=0.545PsAn= 1016R2=0.560p-valuep-valuep-valuep-valuep-valuep-valueFemale gender0.1460.017<0.0010.001<0.001Age0.0540.0480.0760.0560.4960.003University education0.060NS0.8750.0390.044<0.001BMI0.4280.1160.2070.0040.6460.309Ever alcohol intake0.072NS0.7960.5310.5390.035Fibromyalgia<0.0010.4730.052<0.0010.692<0.001Uveitis0.028NS0.832NSNS0.225IBDNSNS0.341NS0.0250.657Axial diseaseNS0.8670.003NSNS0.006Peripheral disease0.039NSNS<0.001NSNSPGA<0.001**<0.001**BASFI<0.001<0.001<0.001<0.001<0.001<0.001ASDAS-CRP<0.001NANA<0.001NANADAS44-CRPNS<0.001<0.001NA0.349<0.001csDMARD0.1560.796NS0.2330.002NSbDMARD0.4910.8960.0210.901NSNSGlucocorticoids0.2950.9880.0350.6920.8030.814NSAID intake score0.998<0.0010.6590.0110.0280.685NS – not significant in univariable model; NA – not applicable; * - colinear with DAS44-ConclusionIn all types of SpA, DA and function are major determinants of HRQoL, passible of tight monitoring and therapeutic intervention. In GH, besides DA and function, socio-demographic factors, like gender and education, also play an important role, in all forms of SpA, highlighting the importance of a holistic approach of the individual patient in order to achieve better outcomes.AcknowledgementsThe authors would like to thank all ASAS-PerSpA investigators and members of the scientific committee.Disclosure of InterestsNone declared