Health-related quality of life in patients with ankylosing spondylitis under biologic therapy

Abstract

Background: Ankylosing spondylitis (AS) is a chronic inflammatory disorder that affects young adults of productive age, leading to impairment of health-related quality of life (HRQoL). This cross-sectional study aimed to assess HRQoL and work productivity in patients with AS on biologic therapy, to explore its relationship with clinical data and radiographic severity. Methods: Eighty AS patients were included. Patients were evaluated using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Short Form-36 (SF-36), Ankylosing Spondylitis Quality of Life (ASQoL), and Work Productivity and Activity Impairment Questionnaire (WPAI: AS). Spondyloarthritis Research Consortium of Canada MRI index (SPARCC) was used for radiological assessment of sacroilitis. Results: Among the 80 AS patients included, 49 patients (61.3%) reported poor quality of life (QoL). Magnetic resonance imaging showed active inflammation in 36 patients (45%) and structural lesions in 80 patients (100%). There were positive correlations between the ASQoL and smoking (r = 0.238, p = 0.034), diagnostic delay (r = 0.298, p = 0.012), duration of current bDMARDs (r = 0.237, p = 0.035), peripheral joint involvement (r = 0.404, p < 0.001), BASDAI (r = 0.245, p = 0.028), BASFI (r = 0.349, p = 0.002), BASMI (r = 0.283, p = 0.011), role limitation due to physical health (r = 0.466, p = 0.029), presenteeism (r = 0.362, p = 0.011), activity impairment (r = 0.624, p < 0.001) and work impairment (r = 0.286, p = 0.047). while negative correlations were noted between ASQoL and employment status (r = -0.223, p = 0.047), vitality (r = -0.235, p = 0.036), and mental health (r = -0.227, p = 0.043). The current biologic therapy duration, BASDAI, BASMI, in addition to human leukocyte antigen B27 (HLA-B27) positivity, were significant predictors of QoL. Conclusion: Health-related quality of life might be affected in patients with ankylosing spondylitis undergoing biologic therapy, emphasizing the importance of routinely incorporating HRQoL assessments into their clinical management.