Impact of the Specific Features of Disease Course and Therapy on Quality of Life in Patients With Ankylosing Spondylitis

Spondyloarthritides (SpAs) is a group of chronic inflammatory diseases of the spine, joints, and entheses characterized by common clinical, radiological, and genetic features. According to international guidelines, one of the main goals of SpA treatment is to ensure the longest possible preservation of the patient's quality of life (QOL). The use of biological agents (BAs) allows rapid clinical improvement and positively affects QOL in patients.Objective: to evaluate the efficacy of BAs on QOL in patients with SpA in real clinical practice.Patients and methods. A total of 280 patients with SpA were examined. The inclusion criteria were ≥18 years of age; compliance of the clinical picture of the disease with the ASAS criteria for axial SpA (2009) or peripheral SpA (2011); and signing the informed consent form. Disease activity was assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS); the functional status of the patients was estimated by the Bath Ankylosing Spondylitis Functional Index (BASFI), and their spinal mobility was evaluated by the Bath Ankylosing Spondylitis Metrology Index (BASMI); ASAS HI was used to comprehensively evaluate the impact of SpA on the patient's health. The European QL EQ-5D-5L and the SF-36 questionnaire were applied to determine quality of life in the patients.Results and discussion. The patients' mean age was 40.19±11.9 years; there was a male preponderance (64%); the HLA-B7-pisitive patients were 78%. The median scores were 5.40 [3.12; 6.80] for BASDAI, 3.37 [2.58; 4.15] for ASDAS, 5.30 [2.60; 7.50] for BASFI, 4.00 [2.60; 6.15] for BASMI, and 9.00 [7.00; 12.00] for ASAS HI. Forty-four patients received a variety of BAs. Patients receiving and not receiving BAs were matched for age and gender; however, the patients on biological therapy (BT) had longer disease duration and lower disease activity according to the ASDAS. There were no statistically significantly difference between the two groups in disease activity according to the BASDAI and in functional disorders according to the BASFI; but there was a tendency towards lower values in the patients on BT. Comparison of QOL in the patients of the two groups revealed statistically significant differences in SF-36 pain scale scores (p=0.02) and EQ-5D-5L indicators (p<0.01).Conclusion. BT makes it possible to successfully achieve one of the main goals of treating patients with SpA, namely to preserve QOL. The patients receiving BAs had longer disease duration, while they were comparable to those not receiving this treatment in terms of the degree of functional disorders.

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Quality of life in spondyloarthritis patients receiving biological therapy

Акулова

Дорогойкина

Гайдукова

et al. 2019

Sovremennaâ revmatologiâ

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Features of the course of ankylosing spondylitis depending on the psychosocial status and duration of the disease

Blaginina

2022

Med. vestn. Ûga Ross.

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Purpose: to study the influence of psychosocial indicators and duration of the disease on the quality of life (QL), anxiety-depressive spectrum disorders (ADSD) and clinical and laboratory activity in patients with ankylosing spondylitis (AS). Materials and methods: the study involved 112 patients with AS. The author assessed clinical and laboratory activity of the disease, QOL (SF-36), the presence of ADSD (using the Taylor, Hamilton, and Spielberger scales), and autonomic disorders depending on the duration of the disease and the level of education. Results: in most patients with AS, signs of ADSD were detected, while in persons with higher education (HE), ADSD were significantly more common, and they had a higher level of anxiety and depression. Patients with HE have lower vital activity, the ability to adapt to social functioning, and an indicator of mental health. The study of the effect of AS duration on QL allowed the author to establish an association between an increase in AS duration and a decrease in the indicator of the psychological component of health. Conclusions: male patients with a higher level of education, who are characterized by lower indicators of QOL, mainly psychological health, have a greater tendency to develop ADSD. An increase in the duration of AS disease does not affect the development of ADSD. With the duration of AS for over 10 years, the indicators of the psycho-emotional and physical components of QOL decrease. There is a tendency in the increase in anxiety and depression levels, antioxidant protection factors are getting exhausted, inflammatory activity progresses, and personal perception of pain intensifies.

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Impact of the Specific Features of Disease Course and Therapy on Quality of Life in Patients With Ankylosing Spondylitis

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References 12 publications

Quality of life in spondyloarthritis patients receiving biological therapy

Quality of life in spondyloarthritis patients receiving biological therapy

Features of the course of ankylosing spondylitis depending on the psychosocial status and duration of the disease

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