Similar alteration for mental and physical aspects in health-related quality of life over 5 to 8\u2009years in 1347 patients with early arthritis and early inflammatory back pain

Abstract

IntroductionHealth-related quality of life (HRQoL) is a priority for patients. The objectives were to describe the changes in HRQoL over 5–8 years in patients with early arthritis (EA) or early inflammatory back pain (IBP) and to explore factors associated to HRQoL.Patients and methodsIn 2 prospective observational French cohorts (ESPOIR for EA patients and DESIR for early IBP patients), HRQoL was assessed regularly over 5–8 years, using the SF36 physical and mental composite scores (PCS and MCS, range 0–100). Disease activity was assessed by DAS28-ESR and ASDAS-CRP. Univariate and multivariate linear mixed-effect models and trajectory-based mapping were applied.ResultsIn all, 1347 patients (701 EA and 646 early IBP) were analysed: mean age 48.4 ± 12.2 and 33.9 ± 8.7 years respectively; mean disease duration 3.4 ± 1.7 and 18.2 ± 10.8 months; and 76.3% and 55.0% females. At baseline, in EA, mean PCS and MCS were respectively 40.2 ± 9.1 and 40.4 ± 11.2 and, in early IBP, were respectively 38.5 ± 8.5 and 39.8 ± 10.9. Over follow-up, HRQoL mean levels improved mostly over the first 6 months (p < 0.001). Two trajectories were evidenced in both diseases. The ‘good HRQoL’ trajectory groups, i.e. 54–61% of patients, reached levels of HRQoL close to population norms. DAS28-ESR and ASDAS-CRP over time were related to PCS (range of explained variance 9–43%, p < 0.001 in the mixed models) but not to MCS.ConclusionHRQoL was altered similarly for both physical and mental aspects in EA and early IBP. Disease activity only partly explained HRQoL: the drivers of HRQoL should be further explored.