在早期轴性脊柱关节炎（早期发现的脊柱关节炎队列）中，疾病活动度降低与1年工作生产力的改善相关。
Disease activity decrease is associated with improvement in work productivity over 1 year in early axial spondyloarthritis (SPondyloArthritis Caught Early cohort).
作者信息
van Lunteren Miranda, Ez-Zaitouni Zineb, Fongen Camilla, Landewé Robert, Ramonda Roberta, van der Heijde Désirée, van Gaalen Floris A
机构信息
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Rheumatology, Diakonhjemmet Hospital, Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Oslo, Norway.
出版信息
Rheumatology (Oxford). 2017 Dec 1;56(12):2222-2228. doi: 10.1093/rheumatology/kex365.
OBJECTIVES
To assess if a change in disease activity is associated with a change in work productivity loss (WPL) over 1 year in early axial SpA (axSpA) patients.
METHODS
Baseline and 1 year data of axSpA patients in the SPondyloArthritis Caught Early cohort were analysed. Linear regression models were built explaining the change in the Ankylosing Spondylitis Disease Activity Score (ASDAS) over time by the change in absenteeism, presenteeism, WPL and activity impairment over time. Effect modification and confounding were tested for age, gender, arm of Assessment of SpondyloArthritis international Society classification criteria, HLA-B27, duration of chronic back pain, profession and medication.
RESULTS
At baseline, in 105 axSpA patients (48% female, mean age 30.8 years, mean symptom duration 13.6 months, 92% HLA-B27 positive, 24% radiographic sacroiliitis), the mean ASDAS was 2.4 (s.d. 1.0), absenteeism 9% (s.d. 23), presenteeism 33% (s.d. 28), WPL 36% (s.d. 30) and activity impairment 37% (s.d. 25). After 1 year, the mean ASDAS decreased to 2.0 (s.d. 0.8) and absenteeism, presenteeism, WPL and activity impairment improved to 6% (s.d. 22), 26% (s.d. 26), 27% (s.d. 29) and 27% (s.d. 26), respectively. Models showed that if ASDAS decreased 1 unit, absenteeism, presenteeism, WPL and activity impairment improved by 5, 17, 16 and 18%, respectively. The impact of disease activity on work productivity was higher in patients with shorter symptom duration and the impact on absenteeism was higher in patients starting pharmacological treatment.
CONCLUSIONS
In early axSpA patients, work productivity and daily activities are seriously impacted at baseline and 1 year. However, decreasing disease activity is associated with marked improvements in work productivity and daily activities.
目的
评估早期中轴型脊柱关节炎（axSpA）患者疾病活动度的变化是否与1年内工作效率损失（WPL）的变化相关。
方法
分析了早期脊柱关节炎队列中axSpA患者的基线数据和1年数据。建立线性回归模型，通过旷工、出勤主义、WPL和活动障碍随时间的变化来解释强直性脊柱炎疾病活动度评分（ASDAS）随时间的变化。对年龄、性别、国际脊柱关节炎协会分类标准分组、HLA-B27、慢性背痛持续时间、职业和药物治疗进行效应修正和混杂检验。
结果
基线时，105例axSpA患者（48%为女性，平均年龄30.8岁，平均症状持续时间13.6个月，92% HLA-B27阳性，24%有影像学骶髂关节炎），平均ASDAS为2.4（标准差1.0），旷工率9%（标准差23），出勤主义33%（标准差28），WPL 36%（标准差30），活动障碍37%（标准差25）。1年后，平均ASDAS降至2.0（标准差0.8），旷工、出勤主义、WPL和活动障碍分别改善至6%（标准差22）、26%（标准差26）、27%（标准差29）和27%（标准差26）。模型显示，如果ASDAS降低1个单位，旷工、出勤主义、WPL和活动障碍分别改善5%、17%、16%和18%。症状持续时间较短的患者中，疾病活动度对工作效率的影响更大，而开始药物治疗的患者中，疾病活动度对旷工的影响更大。
结论
在早期axSpA患者中，工作效率和日常活动在基线和1年时受到严重影响。然而，疾病活动度降低与工作效率和日常活动的显著改善相关。
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