ASAS Health Index in patients with spondyloarthritis and its association with disease activity and disease burden including fibromyalgia

Abstract

Objective. To evaluate the association of the Assessment of Spondyloarthritis international Society Health Index (ASAS-HI) with disease activity and disease burden in patients with spondyloarthritis (SpA). Methods. Observational, cross-sectional and single-centre study from the Córdoba AxSpA Task force, Registry and Outcomes (CASTRO). Scores related to disease activity (BASDAI and ASDAS), functionality (BASFI), structural damage, mobility, health and the presence of concomitant fibromyalgia (FM) were obtained from all patients. ASAS-HI score was considered the main outcome. Pearson's r statistic, Student's t test, and univariate and multivariate linear regressions were performed to assess the association between the ASAS-HI score and the studied covariates. Results. A total of 126 SpA patients were included. The mean ASAS-HI score was 4.6±3.9, showing a "strong" positive linear correlation (r>0.60) with the BASDAI and BASFI and a "moderate" positive linear correlation (r=0.40 to 0.60) with the global VAS and ASDAS. Patients with FM showed a significantly higher ASAS-HI score than patients without FM (9.5±3.2 vs. 3.7±3.4, respectively, p<0.01). Multiple linear regression showed that 57.4% of the ASAS-HI variability (R 2 =0.574) was explained by the presence of concomitant FM (β=2.23, 95% CI 0.73 to 3.80, p=0.004), higher scores on the BASDAI (β=0.62, 95% CI 0.25 to 0.97, p=0.001) and BASFI (β=0.57, 95% CI 0.26 to 0.88, p=0.001). Conclusion. The impairment of health in patients withSpA was mainly associated with high disease activity, worsening functionality and with the presence of a possible concomitant FM. Therefore, in patients with high ASAS-HI scores we must evaluate the presence of concomitant FM.

Association of anxiety, depression and resilience with overall health and functioning in axial spondyloarthritis (axSpA): a cross-sectional study

“…Univariable linear regression analyses were used to determine the association between each variable and the ASAS HI score. Variables were selected based on previous literature 24 26 47 48. Variables with p<0.1 in the univariable analyses were then included in a multivariable analysis, and was considered to be significant if p<0.05.…”

Impact of disease outcomes on the Assessment of SpondyloArthritis International Society Health Index (ASAS HI): a Bayesian network analysis of the DESIR cohort

“…One reason might be the low proportion of patients with spinal mobility impairment or structural damage in our study possibly due to the fact that DESIR is an inception cohort. Nevertheless, in two recent studies, no association between ASAS HI and structural damage was found, 9 10 while a third recent study found no association between health status and structural damage but an association between health status and spinal mobility. 26 In the latter study, health status was assessed using the Ankylosing Spondylitis Health Assessment Questionnaire.…”

“…Our model agrees with the stratified model proposed by Machado et al 5 regarding the association of overall functioning and health with disease activity and physical function, which was also found in previous studies on ASAS HI. 9 10 26 The health status in the former study was assessed using the mental and physical component scores of the SF-36 health survey questionnaire. Our study design differs in several ways: First, we used the ASAS HI, which is a disease-specific patient-reported outcome assessing overall functioning and health in patients with axSpA.…”

“…To our knowledge, few studies have examined the interrelationships between ASAS HI and disease outcomes in patients with axSpA. 9 10 The Devenir des Spondylarthropathies Indifferénciées Récentes (DESIR) cohort provides an unselected population of patients with axSpA, 11 including patients with r-and nr-axSpA. This wide variety of severity and disease activity is an ideal patient sample to assess the relationships of different disease outcomes with ASAS HI from a multidependent perspective.…”

Neuropathic and Nociplastic Pain Profiles are Common in Adult Chronic Nonbacterial Osteitis (CNO)

“…Our study therefore suggests that the presence of mixed pain complicate the interpretation of pain scores and their accuracy in reflecting the state of inflammation. Indeed, in other musculoskeletal diseases, mixed pain is increasingly recognized as an important contextual factor in the evaluation of disease activity [ 33 , 49 ], associated with higher pain scores despite similar levels of inflammatory activity [ 50 – 52 ].…”