Kang Kwi Young, Adler Brittany L, Chung Tae Hwan
Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD 21224, USA.
Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
J Clin Med. 2025 Jun 24;14(13):4474. doi: 10.3390/jcm14134474.
: We aimed to investigate the factors associated with changes in the global functioning of patients with axial spondyloarthritis (axSpA) and to identify predictors of improvement. : One-hundred-and-eighty-five patients enrolled in the Incheon Saint Mary's axSpA prospective observational cohort were evaluated. Global functioning was assessed at baseline and at 1-year follow-up using the ASAS health index (HI). Improvement was defined as a reduction in the ASAS HI of ≥3. Physical function was assessed using the Bath Ankylosing Spondylitis Functional Index (BASFI). Disease activity measures included Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS), and C-reactive protein (CRP) levels. Predictors of improved global functioning were identified by logistic regression analysis. : Nineteen patients (10%) showed improved global functioning at 1-year follow-up versus baseline. Univariate linear regression analysis identified body mass index at baseline, the use of TNF inhibitors, a change in the BASFI and BASDAI, and changes in CRP levels as being associated with changes in the ASAS HI. Multivariate analysis revealed that changes in the BASFI and BASDAI were associated independently with a change in the ASAS HI. Univariate logistic regression analysis revealed that a decrease in the BASFI, BASDAI, ASDAS, and CRP levels predicted improved global functioning. Multivariate analysis identified a decrease in the BASFI and BASDAI as a significant predictor of improved global functioning (odds ratio (95% CI) = 1.465 (1.006-2.135) and 1.414 (1.044-1.914), respectively). : Changes in physical function and disease activity were associated independently with changes in global functioning assessed by the ASAS HI in axSpA. A decrease in the BASFI and BASDAI was a significant predictor of improvement in the ASAS HI.
我们旨在研究与中轴型脊柱关节炎（axSpA）患者整体功能变化相关的因素，并确定改善的预测指标。对185名纳入仁川圣母医院axSpA前瞻性观察队列的患者进行了评估。使用强直性脊柱炎协会健康指数（HI）在基线和1年随访时评估整体功能。改善定义为强直性脊柱炎协会HI降低≥3。使用巴斯强直性脊柱炎功能指数（BASFI）评估身体功能。疾病活动指标包括巴斯强直性脊柱炎疾病活动指数（BASDAI）、强直性脊柱炎疾病活动评分（ASDAS）和C反应蛋白（CRP）水平。通过逻辑回归分析确定整体功能改善的预测指标。19名患者（10%）在1年随访时与基线相比整体功能有所改善。单变量线性回归分析确定基线时的体重指数、TNF抑制剂的使用、BASFI和BASDAI的变化以及CRP水平的变化与强直性脊柱炎协会HI的变化相关。多变量分析显示，BASFI和BASDAI的变化与强直性脊柱炎协会HI的变化独立相关。单变量逻辑回归分析显示，BASFI、BASDAI、ASDAS和CRP水平的降低预示着整体功能的改善。多变量分析确定BASFI和BASDAI的降低是整体功能改善的重要预测指标（优势比（95%CI）分别为1.465（1.006 - 2.135）和1.414（1.044 - 1.914））。在axSpA中，身体功能和疾病活动的变化与通过强直性脊柱炎协会HI评估的整体功能变化独立相关。BASFI和BASDAI的降低是强直性脊柱炎协会HI改善的重要预测指标。
