AB0865 The Factors affecting patient global assesment in patients with Axial Spondyloarthritis

Abstract

BackgroundThe BASDAI is one of the basic scales used in the measurement of disease activity in patients with spondyloarthritis and allows the evalution of various aspects of the disease (axial and peripheral disease as well as inflammation). The patient global assesment (PGA) is a one-dimensional scale in which patients evaluate how their illness affects their health.ObjectivesIn this study, we planned to test and review the possible determinants of PGA and its relation with BASDAI components, BASFI scores and disease-related features both at first visit and at the 2 year follow-up.MethodsPatients with axSpA whose baseline BASDAI and PGA scores were complated, were included in the analysis. The demographic, clinical and laboratory characteristics of the patients were recorded. The relation between PGA scores and BASDAI sub-score, BASFI score and other patient and disease characteristics were tested both univariate and multivariate analysis methods. The factors affecting the change in the PGA score over 2-year follow-up were also analyzed with GEE analysis method.ResultsIn total 313 patients (56.5% of male, 61.7% AS, mean age at diagnosis 34.3±11 years) were included in the analysis. Sperman’s rho test was used for correlation analysis. Baseline PGA scores were in correlation with the BASDAI total score (rho:0.71, p&lt;0.001). PGA scores of female patients were found to be significantly higher (p=0.037) and each BASDAI indivual score and BASFI scores were moderately/well correlated with PGA (Table 1). Multivariate analysis revealed that spinal pain (BASDAI Q2), the severity of morning stiffness (BASDAI Q5) and BASFI scores were the main determinants in the global health assesments of patients with axSpA (Table 1). GEE analysis was performed to evaluate the factors affecting the 2 year change in the PGA of the patients, fatigue (BASDAI Q1) (B:1.575, CI%95: [0.241- 2.922]; p=0.021), enthesis (BASDAI Q4) (B:0.888, CI95% [0.049-1.727]; p=0.038) severity of morning stiffness (BASDAI Q5) (B: 2.663, CI%95 [1.447-3.878]; p&lt;0.001),and BASFI scores (B: 2.909, CI95% [1.806-4.011]; p&lt;0.001) were independent determinants of PGA in longitudinal analysis.Table 1.Baseline PGA related factorsSperman AnalysisModel 1Model 2rhopB (%95 CI)pB (%95 CI)psex0.120.037-3.183 (-8.903; 2.538)0.27-3.612 (-9.372; 2.148)0.22BASDAI Q10.59&lt;0.0010.614 (-0.936;2.175)0.440.861 (-0.686; 2.406)0.27BASDAI Q20.66&lt;0.0013.168 (1.536; 4.800)&lt;0.0013.231 (1.587; 4.874)&lt;0.001BASDAI Q30.43&lt;0.0010.619 (-0.613; 1852)0.320.538 (-0.703; 1.779)0.39BASDAI Q40.43&lt;0.0010.374 (-0.741;1.489)0.510.529 (-0.587; 1.645)0.35BASDAI Q50.60&lt;0.0012.088 (0.542; 3.634)0.008BASDAI Q60.43&lt;0.001-0.697(-2.053;0.660)0.31BASDAI (Q5+Q6)/20.56&lt;0.0011.195 (-0.218; 2.608)0.097BASFI0.62&lt;0.0012.097 (0.273-3.921)0.022.263 (0.433; 4.094)0.016BASMI0.28&lt;0.001-0.321 (-1.879;1.237)0.69-0.319(-1.891; 1.253)0.69Serum CRP level0.23&lt;0.0010.066 (-0.100;0.233)0.430.073 (-0.094; 0.241)0.39ConclusionThe study shows that the patients with axSpA mainly rely on morning stiffness and spinal pain in deciding their global health status. Fatigue, enthesis and morning stiffness were found to be effective factors in the PGA changes of the patients under treatment. Although PGA is unidimentional, its well correlation with the BASDAI total score may be another proof of the validity of both scales.Disclosure of InterestsNone declared</jats:sec