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Arthritis Res Ther. 2019 Feb 19;21(1):63. doi: 10.1186/s13075-019-1841-y.

Similar alteration for mental and physical aspects in health-related quality of life over 5 to 8 years in 1347 patients with early arthritis and early inflammatory back pain.

Author information

1
Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS), Paris, France. debozem@gmail.com.
2
Department of rheumatology, AP-HP, Pitié Salpêtrière Hospital, Paris, France. debozem@gmail.com.
3
Hôpital Pitié-Salpêtrière, Service de Rhumatologie, 47-83, boulevard de l'Hôpital, 75013, Paris, France. debozem@gmail.com.
4
Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS), Paris, France.
5
Department of Biostatistics, Public Health and Medical Information, AP-HP, Pitié Salpêtrière Hospital, Paris, France.
6
Paris Descartes University, Department of Rheumatology- HopitalCochin, Paris, France.
7
INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris- Cité, Paris, France.
8
Nîmes University Hospital, Department of Rheumatology, EA 2415, University of Montpellier, 30029, Nîmes, France.
9
Université de Lorraine, EA 4360 APEMAC and Inserm CIC, 1433 Epidémiologie clinique, CHRU de Brabois, Nancy, France.
10
CHU de Toulouse, Hôpital Pierre-Paul Riquet, Toulouse, France.
11
UMR1027, Inserm, Faculté de Médecine, Université Paul Sabatier, Toulouse, France.
12
Department of rheumatology, AP-HP, Pitié Salpêtrière Hospital, Paris, France.

Abstract

INTRODUCTION:

Health-related quality of life (HRQoL) is a priority for patients. The objectives were to describe the changes in HRQoL over 5-8 years in patients with early arthritis (EA) or early inflammatory back pain (IBP) and to explore factors associated to HRQoL.

PATIENTS AND METHODS:

In 2 prospective observational French cohorts (ESPOIR for EA patients and DESIR for early IBP patients), HRQoL was assessed regularly over 5-8 years, using the SF36 physical and mental composite scores (PCS and MCS, range 0-100). Disease activity was assessed by DAS28-ESR and ASDAS-CRP. Univariate and multivariate linear mixed-effect models and trajectory-based mapping were applied.

RESULTS:

In all, 1347 patients (701 EA and 646 early IBP) were analysed: mean age 48.4 ± 12.2 and 33.9 ± 8.7 years respectively; mean disease duration 3.4 ± 1.7 and 18.2 ± 10.8 months; and 76.3% and 55.0% females. At baseline, in EA, mean PCS and MCS were respectively 40.2 ± 9.1 and 40.4 ± 11.2 and, in early IBP, were respectively 38.5 ± 8.5 and 39.8 ± 10.9. Over follow-up, HRQoL mean levels improved mostly over the first 6 months (p <  0.001). Two trajectories were evidenced in both diseases. The 'good HRQoL' trajectory groups, i.e. 54-61% of patients, reached levels of HRQoL close to population norms. DAS28-ESR and ASDAS-CRP over time were related to PCS (range of explained variance 9-43%, p <  0.001 in the mixed models) but not to MCS.

CONCLUSION:

HRQoL was altered similarly for both physical and mental aspects in EA and early IBP. Disease activity only partly explained HRQoL: the drivers of HRQoL should be further explored.

KEYWORDS:

Axial spondyloarthritis; Early arthritis; Early inflammatory back pain; Patient outcomes assessment; Quality of life; Rheumatoid arthritis

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