This study’s primary objective was to determine the long‐term association between disease activity and disability in axial spondyloarthritis (axSpA). Our secondary objective was to define patient profiles according to their level of disability.
We analyzed data collected during the first five years of follow‐up of a large early axSpA cohort – the Devenir des Spondylarthropathies Indifferénciées Récentes (DESIR) cohort. Hierarchical multivariable analysis was conducted using the Chi‐square Automatic Interaction Detector (CHAID) method to determine how variables best cluster to explain HAQ‐AS. Data from 644 patients and 5152 visits were analyzed. HAQ‐AS was longitudinally, independently and positively associated with ASDAS‐CRP [adjusted (adj) B=0.205, (95% confidence interval (CI)= 0.187 to 0.222], enthesitis score (adjB=0.011, CI=0.008 to 0.015), Bath Ankylosing Spondylitis Metrology Index (BASMI) (adjB=0.087, CI=0.069 to 0.105) and female gender (adjB=0.172, CI=0.120 to 0.225). The CHAID decision tree revealed ASDAS‐CRP as the first variable with discriminative power on HAQ‐AS.
In conclusion, disease activity contributes longitudinally to disability and is hierarchically superior to any other variable in explaining this health domain. Enthesitis and spinal mobility are also critical drivers of disability in early axSpA.
Ref: https://onlinelibrary.wiley.com/doi/10.1002/acr.24515
