Disease activity trajectories in early axial spondyloarthritis: results from the DESIR cohort

Moltó, Anna; Montcel, Sophie Tezenas du; Wendling, Daniel; Dougados, Maxime; Vanier, Antoine; Gossec, Laure

doi:10.1136/annrheumdis-2016-209785

Cited by 28 publications

(34 citation statements)

References 36 publications

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“…The prospective study DEvenir des Spondyloarthrites Indifférenciées Récentes (DESIR) examined trajectories of disease and factors associated with them. The study noted that white-collar work was associated with the trajectory "persistent inactive" disease 24 . Ramiro, et al 25 reported in a longitudinal analysis of 136 patients that the relationship between disease activity and radiographic progression was significantly and independently modified by job type.…”

Section: Discussionmentioning

confidence: 98%

Identifying Persons with Axial Spondyloarthritis At Risk of Poor Work Outcome: Results from the British Society for Rheumatology Biologics Register

Macfarlane

Shim²,

Jones³

et al. 2018

J Rheumatol

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Objective.First, to test the hypothesis that, among working patients with axial spondyloarthritis (axSpA), those who report issues with reduced productivity at work (presenteeism) are at higher risk of work absence (absenteeism), and patients who report absenteeism are at higher risk of subsequently leaving the workforce. Second, to identify characteristics of workers at high risk of poor work outcome.Methods.The British Society for Rheumatology Biologics Register in Ankylosing Spondylitis has recruited patients meeting Assessment of Spondyloarthritis international Society criteria for axSpA from 83 centers. Data collection involved clinical and patient-reported measures at recruitment and annually thereafter, including the Work Productivity and Activity Impairment scale. Generalized estimating equations were used to identify factors associated with poor work outcomes.Results.Of the 1188 participants in this analysis who were working at recruitment, 79% reported some presenteeism and 19% some absenteeism in the past week owing to their axSpA. Leaving employment was most strongly associated with previous absenteeism (RR 1.02 per % increase in absenteeism, 95% CI 1.01–1.03), which itself was most strongly associated with previous presenteeism, a labor-intensive job, and peripheral joint involvement. High disease activity, fatigue, a labor-intensive job, and poorer physical function were all independently associated with future presenteeism.Conclusion.Clinical and patient-reported factors along with aspects of work are associated with an increased risk of axSpA patients having a poor outcome in relation to work. This study has identified modifiable factors as targets, facilitating patients with axSpA to remain productive at work.

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Section: Discussionmentioning

confidence: 98%

Identifying Persons with Axial Spondyloarthritis At Risk of Poor Work Outcome: Results from the British Society for Rheumatology Biologics Register

Macfarlane

Shim²,

Jones³

et al. 2018

J Rheumatol

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“…The five revealed disease impact trajectories and their characterisations are largely consistent with the reported disease activity trajectories by Moltó et al . 17 For example, the largest proportion of females, highest BASDAI-scores and BASFI-scores can be found in the trajectory very high impact (t5)/persistently very high disease activity. Conversely, younger patients in combination with prescription of TNF-α-inhibitors characterise the trajectory high impact with major improvement (t3)/changing disease activity.…”

Section: Discussionmentioning

confidence: 98%

“…To gain such understanding, Moltó et al evaluated in a French cohort of patients with early axSpA the presence of potential latent subgroups with respect to disease activity during a 3-year follow-up period. 17 Five disease activity trajectories were observed: (1) persistent moderate disease activity; (2) persistent inactive disease; (3) changing disease activity; (4) persistent high disease activity; (5) persistent very high disease activity. Interestingly, in their study, a relation between the disease activity trajectories and the level of HRQoL at baseline was established.…”

Section: Introductionmentioning

confidence: 98%

Uncovering the heterogeneity of disease impact in axial spondyloarthritis: bivariate trajectories of disease activity and quality of life

et al. 2018

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ObjectiveThe goal of managing axial spondyloarthritis (axSpA) is to improve and maintain patients’ health-related quality of life (HRQoL), mainly through targeting towards low disease activity. Here, we aim to gain insight into the joint evolution of HRQoL and disease activity by identifying and characterising latent subgroups of patients with longstanding disease displaying similar trajectories throughout 8 years of follow-up.MethodsData from Outcome in Ankylosing Spondylitis (AS) International Study (n=161) and Groningen Leeuwarden AS cohort (n=264) were used. Biennially, HRQoL was assessed by AS Quality of Life (ASQoL) and disease activity by AS Disease Activity Score—C reactive protein (ASDAS-CRP). Bivariate trajectories of these outcomes were estimated by group-based trajectory modelling. Next, trajectories were profiled by comparing the latent groups with respect to baseline factors using analysis of variance and χ² test.ResultsFive bivariate trajectories were distinguished, in which ASQoL and ASDAS-CRP were tightly linked: (t1) low impact of disease; (t2) moderate impact; (t3) high impact with major improvement; (t4) high impact with some improvement; (t5) very high impact. Profiling revealed, for example, that (t1) was characterised by male gender and Human Leucocyte Antigen B27 positivity; (t3) by younger age, shorter symptom duration and biological intake and (t5) by the highest proportion of females.ConclusionsWe identified five bivariate trajectories of HRQoL and disease activity demonstrating a clear mutual relationship. The profiles revealed that both individual-related and disease-related features define the type of disease course in respect to HRQoL and disease activity in axSpA. This may provide clinicians insight into the differences among patients and help in the management of the disease.

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“…In addition, the mean values of ASDAS (baseline 2.5, 1 yr 2.0) and PCS (baseline 28.4, 1 yr 36.9) in our cohort are comparable to other axSpA cohorts. For example, in the Devenir des Spondyloarthrites Indifférenciées Récentes (DESIR) cohort, patients with early axSpA (symptom duration < 3 yrs) had a mean ASDAS of 2.6 and PCS of 41 23 , and in the Herne 24 and Swiss Clinical Quality Management cohorts 25 (nonradiographic axSpA with a symptom duration > 5 yrs), the mean ASDAS ranged from 2.8 to 3.0 and PCS from 20 to 42, respectively. The ESPERANZA cohort has also found an association between the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire 26 .…”

Section: The Association Found Between Disease Activity Andmentioning

confidence: 99%

In Early Axial Spondyloarthritis, Increasing Disease Activity Is Associated with Worsening of Health-related Quality of Life over Time

Lunteren

Ez-Zaitouni²,

Koning³

et al. 2018

J Rheumatol

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Disease activity trajectories in early axial spondyloarthritis: results from the DESIR cohort

Abstract: NCT01648907.

Cited by 28 publications

References 36 publications

Identifying Persons with Axial Spondyloarthritis At Risk of Poor Work Outcome: Results from the British Society for Rheumatology Biologics Register

Identifying Persons with Axial Spondyloarthritis At Risk of Poor Work Outcome: Results from the British Society for Rheumatology Biologics Register

Uncovering the heterogeneity of disease impact in axial spondyloarthritis: bivariate trajectories of disease activity and quality of life

In Early Axial Spondyloarthritis, Increasing Disease Activity Is Associated with Worsening of Health-related Quality of Life over Time

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