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Oxford University Press, Rheumatology, 2023

DOI: 10.1093/rheumatology/kead503

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Determinants of health-related quality of life and global functioning and health in axSpA, pSpA, and PsA: results from the ASAS-PerSpA study

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Abstract

Abstract Objectives We aim to identify determinants of health-related quality of life (HRQoL) and global functioning and health (GH) in axial spondyloarthritis (axSpA), peripheral spondyloarthritis (pSpA), and psoriatic arthritis (PsA). Methods ASAS-perSpA study data were analyzed. Models for the three patient groups were performed separately to explore factors associated with HRQoL and GH, assessed by EQ-5D and ASAS-HI, respectively. Results The analyses included 4185 patients: 2719 with axSpA, 433 with pSpA, and 1033 with PsA. In axSpA, disease activity (DA) (β=-0.061), physical function (β=-0.041), female sex (β=-0.019), and fibromyalgia (β=-0.068) were associated with worse HRQoL; age (β = 0.001) and university education (β = 0.014) with better HRQoL. In pSpA, DA (β=-0.04) and physical function (β=-0.054) were associated with worse HRQoL. In PsA, DA (β=-0.045), physical function (β=-0.053), axial disease (β=-0.041), and female sex (β=-0.028) were associated with worse HRQoL. In axSpA, DA (β = 0.889), physical function (β = 0.887), peripheral disease (β = 0.564), female sex (β = 0.812) and fibromyalgia (β = 1.639) were associated with worse GH; age (β=-0.013) and university education (β=-0.274) with better GH. In pSpA, physical function (β = 1.142), and female sex (β = 1.060) were associated with worse GH; university education (β=-0.611) with better GH. In PsA, DA (β = 0.703), physical function (β = 1.025), axial involvement (β = 0.659), female sex (β = 0.924), and fibromyalgia (β = 1.387) were associated with worse GH; age (β=-0.024) and university education (β=-0.856) with better GH. Conclusions DA and physical function are major HRQoL and GH determinants across spondyloarthritis types, and clinical characteristics and sociodemographic factors play an important role, highlighting the importance of a holistic approach for individual patients.