Comparison of the ASAS Health Index in patients classified as radiographic axial spondyloarthritis (axSpA) or non-radiographic axSpA in the ASAS Health Index international validation study

Objectives To determine if there were differences in the Assessment of SpondyloArthritis international Society Health Index (ASAS HI) scores between patients classified as radiographic axial spondyloarthritis (r-axSpA) and non-radiographic axSpA (nr-axSpA), and to identify factors associated with hi...

Full description

Saved in:
Bibliographic Details
Main Authors: Désirée van der Heijde, Annelies Boonen, Jürgen Braun, Uta Kiltz, Yu Heng Kwan, Warren Fong, Ting Hui Woon
Format: Article
Language:English
Published: BMJ Publishing Group 2024-02-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/10/1/e003794.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849720772558323712
author Désirée van der Heijde
Annelies Boonen
Jürgen Braun
Uta Kiltz
Yu Heng Kwan
Warren Fong
Ting Hui Woon
author_facet Désirée van der Heijde
Annelies Boonen
Jürgen Braun
Uta Kiltz
Yu Heng Kwan
Warren Fong
Ting Hui Woon
author_sort Désirée van der Heijde
collection DOAJ
description Objectives To determine if there were differences in the Assessment of SpondyloArthritis international Society Health Index (ASAS HI) scores between patients classified as radiographic axial spondyloarthritis (r-axSpA) and non-radiographic axSpA (nr-axSpA), and to identify factors associated with higher ASAS HI scores in both disease phenotypes.Methods This study was an ancillary analysis of the ASAS HI international validation project performed in 23 countries. Patients were included if they were ≥18 years of age and diagnosed with axSpA. Univariable and multivariable analysis were performed to determine if ASAS HI scores differed between the axSpA phenotypes, and to identify other variables associated with ASAS HI scores. We also tested for potential interactions between the axSpA phenotype and significant variables identified through the multivariable regression.Results A total of 976 patients were included, with 703 having r-axSpA and 273 nr-axSpA. Patients with r-axSpA reported higher (worse) ASAS HI scores compared with those with nr-axSpA (6.8 (4.4) vs 6.0 (4.0), p=0.02), but the axSpA phenotype was not associated with ASAS HI scores in the multivariable regression (β: −0.19, 95% CI: −0.56 to 0.19). Female gender, having worse physical function (Bath Ankylosing Spondylitis Functional Index), disease activity (Ankylosing Spondylitis Disease Activity Score) and anxiety and depressive symptoms (Hospital Anxiety and Depression Scale) were associated with higher ASAS HI scores. No interactions were found to be significant.Conclusion Overall health and functioning are similarly affected in patients with r-axSpA and nr-axSpA. Female patients, having worse physical function, disease activity, anxiety and depressive symptoms were independently associated with higher ASAS HI scores.
format Article
id doaj-art-8a9b6da05ea145ef965851122c40aea4
institution DOAJ
issn 2056-5933
language English
publishDate 2024-02-01
publisher BMJ Publishing Group
record_format Article
series RMD Open
spelling doaj-art-8a9b6da05ea145ef965851122c40aea42025-08-20T03:11:52ZengBMJ Publishing GroupRMD Open2056-59332024-02-0110110.1136/rmdopen-2023-003794Comparison of the ASAS Health Index in patients classified as radiographic axial spondyloarthritis (axSpA) or non-radiographic axSpA in the ASAS Health Index international validation studyDésirée van der Heijde0Annelies Boonen1Jürgen Braun2Uta Kiltz3Yu Heng Kwan4Warren Fong5Ting Hui Woon6Rheumatology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and the Caphri Research Institute Maastricht University, Maastricht, The Netherlands1 Ruhr University Bochum, Bochum, Germany2 Ruhr-Universität Bochum, Bochum, Nordrhein-Westfalen, GermanyProgram in Health Services and Systems Research, Duke-NUS Medical School, SingaporeDepartment of Rheumatology and Immunology, Singapore General Hospital, SingaporeDepartment of Rheumatology and Immunology, Singapore General Hospital, SingaporeObjectives To determine if there were differences in the Assessment of SpondyloArthritis international Society Health Index (ASAS HI) scores between patients classified as radiographic axial spondyloarthritis (r-axSpA) and non-radiographic axSpA (nr-axSpA), and to identify factors associated with higher ASAS HI scores in both disease phenotypes.Methods This study was an ancillary analysis of the ASAS HI international validation project performed in 23 countries. Patients were included if they were ≥18 years of age and diagnosed with axSpA. Univariable and multivariable analysis were performed to determine if ASAS HI scores differed between the axSpA phenotypes, and to identify other variables associated with ASAS HI scores. We also tested for potential interactions between the axSpA phenotype and significant variables identified through the multivariable regression.Results A total of 976 patients were included, with 703 having r-axSpA and 273 nr-axSpA. Patients with r-axSpA reported higher (worse) ASAS HI scores compared with those with nr-axSpA (6.8 (4.4) vs 6.0 (4.0), p=0.02), but the axSpA phenotype was not associated with ASAS HI scores in the multivariable regression (β: −0.19, 95% CI: −0.56 to 0.19). Female gender, having worse physical function (Bath Ankylosing Spondylitis Functional Index), disease activity (Ankylosing Spondylitis Disease Activity Score) and anxiety and depressive symptoms (Hospital Anxiety and Depression Scale) were associated with higher ASAS HI scores. No interactions were found to be significant.Conclusion Overall health and functioning are similarly affected in patients with r-axSpA and nr-axSpA. Female patients, having worse physical function, disease activity, anxiety and depressive symptoms were independently associated with higher ASAS HI scores.https://rmdopen.bmj.com/content/10/1/e003794.full
spellingShingle Désirée van der Heijde
Annelies Boonen
Jürgen Braun
Uta Kiltz
Yu Heng Kwan
Warren Fong
Ting Hui Woon
Comparison of the ASAS Health Index in patients classified as radiographic axial spondyloarthritis (axSpA) or non-radiographic axSpA in the ASAS Health Index international validation study
RMD Open
title Comparison of the ASAS Health Index in patients classified as radiographic axial spondyloarthritis (axSpA) or non-radiographic axSpA in the ASAS Health Index international validation study
title_full Comparison of the ASAS Health Index in patients classified as radiographic axial spondyloarthritis (axSpA) or non-radiographic axSpA in the ASAS Health Index international validation study
title_fullStr Comparison of the ASAS Health Index in patients classified as radiographic axial spondyloarthritis (axSpA) or non-radiographic axSpA in the ASAS Health Index international validation study
title_full_unstemmed Comparison of the ASAS Health Index in patients classified as radiographic axial spondyloarthritis (axSpA) or non-radiographic axSpA in the ASAS Health Index international validation study
title_short Comparison of the ASAS Health Index in patients classified as radiographic axial spondyloarthritis (axSpA) or non-radiographic axSpA in the ASAS Health Index international validation study
title_sort comparison of the asas health index in patients classified as radiographic axial spondyloarthritis axspa or non radiographic axspa in the asas health index international validation study
url https://rmdopen.bmj.com/content/10/1/e003794.full
work_keys_str_mv AT desireevanderheijde comparisonoftheasashealthindexinpatientsclassifiedasradiographicaxialspondyloarthritisaxspaornonradiographicaxspaintheasashealthindexinternationalvalidationstudy
AT anneliesboonen comparisonoftheasashealthindexinpatientsclassifiedasradiographicaxialspondyloarthritisaxspaornonradiographicaxspaintheasashealthindexinternationalvalidationstudy
AT jurgenbraun comparisonoftheasashealthindexinpatientsclassifiedasradiographicaxialspondyloarthritisaxspaornonradiographicaxspaintheasashealthindexinternationalvalidationstudy
AT utakiltz comparisonoftheasashealthindexinpatientsclassifiedasradiographicaxialspondyloarthritisaxspaornonradiographicaxspaintheasashealthindexinternationalvalidationstudy
AT yuhengkwan comparisonoftheasashealthindexinpatientsclassifiedasradiographicaxialspondyloarthritisaxspaornonradiographicaxspaintheasashealthindexinternationalvalidationstudy
AT warrenfong comparisonoftheasashealthindexinpatientsclassifiedasradiographicaxialspondyloarthritisaxspaornonradiographicaxspaintheasashealthindexinternationalvalidationstudy
AT tinghuiwoon comparisonoftheasashealthindexinpatientsclassifiedasradiographicaxialspondyloarthritisaxspaornonradiographicaxspaintheasashealthindexinternationalvalidationstudy