Department of Internal Medicine, Fourth Military Teaching Hospital, Wroclaw, Poland.
Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland.
Adv Exp Med Biol. 2021;1335:63-78. doi: 10.1007/5584_2020_611.
Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease involving the axial skeleton, peripheral joints, and extra-articular manifestations like psoriasis, inflammatory bowel disease, or uveitis. A deterioration of quality of life (QoL) affects the disease management and therapeutic decision-making. This meta-analysis focused on the influence of biological drugs on the QoL in SA compared to the effects of other therapeutic modalities. We searched the databases of MedLine, Academic Search Ultimate, CINAHL Complete, and Health Source - Nursing/Academic Edition for articles related to AS treatment using the terms "ankylosing spondylitis" OR "rheumatoid spondylitis" OR "spondylitis" AND "quality of life" OR "patient-reported outcomes" OR "well-being" OR "health-related quality of life" OR "biological treatment". The search came up with 10 English-language articles published between 2010 and 2020. Patients were evaluated with the following indexes and questionnaires: Assessment of Spondyloarthritis International Society (ASAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Quality of Life (ASQoL), 36-Item Short-Form Health Survey (SF-36), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and the Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Functional (BASFI) Indexes. We found that the QoL, assessed with the ASQoL, improved significantly better in patients treated with biological drugs when compared to those treated with other standard therapies or placebo at a 4-month follow-up. However, improvements in other disease characteristics could not be differentiated based on the therapy modality. The finding that biological drugs are superior in improving the QoL should strengthen the recommendations for their use in patients with AS.
强直性脊柱炎（AS）是一种累及中轴骨骼、外周关节和关节外表现的慢性炎症性风湿病，如银屑病、炎症性肠病或葡萄膜炎。生活质量（QoL）的恶化会影响疾病的管理和治疗决策。这项荟萃分析主要关注生物药物对 AS 患者 QoL 的影响与其他治疗方式的影响。我们使用“ankylosing spondylitis”或“rheumatoid spondylitis”或“spondylitis”以及“quality of life”或“patient-reported outcomes”或“well-being”或“health-related quality of life”或“biological treatment”等术语，在 MedLine、Academic Search Ultimate、CINAHL Complete 和 Health Source-Nursing/Academic Edition 数据库中搜索与 AS 治疗相关的文章。搜索结果包括 2010 年至 2020 年期间发表的 10 篇英文文章。患者使用以下指标和问卷进行评估：评估强直性脊柱炎国际学会（ASAS）、巴斯强直性脊柱炎疾病活动指数（BASDAI）、强直性脊柱炎生活质量（ASQoL）、36 项简短健康调查问卷（SF-36）、慢性疾病治疗疲劳功能评估-疲劳（FACIT-F）和巴斯强直性脊柱炎功能指数（BASFI），以及巴斯强直性脊柱炎功能指数（BASFI）。我们发现，与接受其他标准治疗或安慰剂治疗的患者相比，接受生物药物治疗的患者在 4 个月随访时，ASQoL 评估的 QoL 显著改善。然而，基于治疗方式，其他疾病特征的改善无法区分。生物药物在改善 QoL 方面具有优势的发现应该加强在 AS 患者中使用生物药物的建议。
