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Researchers identify prognostic factors for spondyloarthritis outcomes
Low educational level, older age, high disease activity at onset, positive smoking status and female sex were prognostic features of bad functional outcomes in patients with early inflammatory back pain, according to researchers in France.
Researchers studied 513 patients with early inflammatory back pain, 72.2% of whom met the Assessment of Spondyloarthritis (ASAS) International Society criteria, enrolled in the devenir des spondylarthropathies indifférenciées récentes or DESIR, a French, multi-center cohort study. Patients were 54.4% women and the mean age at inclusion was 34.8 years. A bad functional outcome was defined as an increase in the Bath Ankylosing Spondylitis Functional Index (BASFI) above the 75th centile of progression observed in the cohort at 24 months.
Bad outcomes were observed more frequently in patients with disease onset at over age 33 years and in patients with an educational level below college, smokers, women and patients with high disease activity at baseline. Poor outcomes were also observed in patients who did not meet ASAS criteria, HLA-B27-negative patients with normal sacroiliac joints on X-rays or MRI or a history of active peripheral arthritis.
Factors associated with bad functional outcomes at 24 months that persisted after multivariate analysis included female sex, age over 33 years, lower educational level, active smoking, high baseline Bath Ankylosing Spondylitis Disease Activity Index and patients who did not meet ASAS criteria at baseline.
The distribution of and change in the BASFI among patients who met ASAS criteria at baseline was similar among 369 patients with available data, among whom 140 patients had an increase of 3 points or more in BASFI at 2 years. Among the subgroup, women and patients with higher disease activity at baseline were observed in greater proportions. Based on the results, active smoking negatively impacted perceived health through assessment of functional ability and higher education had a protective effect on this. No significant impact was observed with age. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.