Ruiz-Vilchez Desirée, Ladehesa-Pineda Lourdes, Puche-Larrubia María Ángeles, Ábalos-Aguilera María Carmen, Font-Ugalde Pilar, Escudero-Contreras Alejandro, Collantes-Estévez Eduardo, López-Medina Clementina
Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain.
GC05 Group, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain.
Ther Adv Musculoskelet Dis. 2024 Sep 5;16:1759720X241272947. doi: 10.1177/1759720X241272947. eCollection 2024.
Few studies have been conducted to investigate the socioeconomic profiles of patients with ankylosing spondylitis (AS) and their associations with disease severity and disability.
The objectives of this study were to identify clusters of patients with AS according to their socioeconomic characteristics and to evaluate the associations between these clusters and the severity of the disease and permanent disability.
This was a cross-sectional and multicentre study.
Patients with AS from the REGISPONSER study were included in this analysis. A cluster analysis was conducted using information on sociodemographic (age, sex, race, marital status, education) and socioeconomic (employment, profession, housing conditions and social level) characteristics. Disease burden and permanent disability were compared between the different clusters using logistic regression adjusted for disease duration and disease activity.
A total of 866 patients with AS were included. Two clusters were identified according to socioeconomic characteristics: Cluster 1 ( = 476), with a predominantly low socioeconomic profile, and Cluster 2 ( = 390), with a predominantly high socioeconomic profile. After adjusting for disease duration, patients in Cluster 1 had a longer diagnosis delay, greater body mass index and greater structural damage than those in Cluster 2. Access to biologic disease-modifying anti-rheumatic drugs (bDMARDs) was similar for both groups. However, patients in Cluster 1 had a greater prevalence of permanent disability than those in Cluster 2 after adjusting for disease duration and disease activity (30.8% vs 13.2%, odds ratio 2.58 (95% confidence interval 1.76-3.83)).
This study suggests that the socioeconomic status of patients with AS may have implications for disease severity and permanent disability, despite the similar use of bDMARDs.
很少有研究调查强直性脊柱炎（AS）患者的社会经济概况及其与疾病严重程度和残疾的关联。
本研究的目的是根据社会经济特征识别AS患者群体，并评估这些群体与疾病严重程度和永久性残疾之间的关联。
这是一项横断面多中心研究。
纳入REGISPONSER研究中的AS患者进行分析。使用社会人口统计学（年龄、性别、种族、婚姻状况、教育程度）和社会经济（就业、职业、住房条件和社会阶层）特征信息进行聚类分析。使用经疾病持续时间和疾病活动度调整的逻辑回归比较不同群体之间的疾病负担和永久性残疾情况。
共纳入866例AS患者。根据社会经济特征识别出两个群体：群体1（n = 476），主要为社会经济状况较低；群体2（n = 390），主要为社会经济状况较高。在调整疾病持续时间后，群体1的患者比群体2的患者诊断延迟更长、体重指数更高且结构损伤更大。两组使用生物改善病情抗风湿药物（bDMARDs）的情况相似。然而，在调整疾病持续时间和疾病活动度后，群体1的永久性残疾患病率高于群体2（30.8%对13.2%，比值比2.58（95%置信区间1.76 - 3.83））。
本研究表明，尽管bDMARDs的使用情况相似，但AS患者的社会经济状况可能对疾病严重程度和永久性残疾有影响。
