UTILITY OF THE ASAS HEALTH INDEX QUESTIONNAIRE AS A TOOL FOR HEALTH ASSESSMENT IN PATIENTS WITH SPONDYLOARTHRITIS AND ITS ASSOCIATION WITH DISEASE ACTIVITY, FUNCTIONALITY, MOBILITY, AND STRUCTURAL DAMAGE

Background: The ASAS Health Index (ASAS-HI) questionnaire, a tool that measures the impact of the disease on the health in patients with Spondyloarthritis (SpA), has been recently validated. However, there are still no studies evaluating the utility of this questionnaire in daily clinical practice. Objectives: The objective of this study is to evaluate the association of ASAS-HI with disease activity, functionality, mobility, and structural damage in patients with SpA. Methods: This is an observational, cross-sectional and single-center study in which 126 consecutive patients with SpA were included. Sociodemographic data, scores related to disease activity (BASDAI and ASDAS), functionality (BASFI), structural damage (cervical, lumbar and total mSASSS), mobility (BASMI and UCOASMI), quality of life (ASAS-HI) and the presence of concomitant fibromyalgia (evaluated with the FIRST questionnaire) were obtained from all patients. The ASAS-HI questionnaire was considered as the main outcome (scale from 0 to 17). Pearson’s correlation coefficient was used to evaluate the association of the different continuous variables with each other. Student’s t-test was used to compare the ASAS-HI between different subgroups of patients (men vs. women, ASDAS>2,1 vs. ASDAS≤2,1 and fibromyalgia + vs. fibromyalgia-). Finally, a multivariate linear regression was performed to determine which factors explain the variability of ASAS-HI in these patients Results: Among the 126 patients included, 83 (65.9%) were men, with a mean age of 45.1±12.3 years and a mean disease duration of 18.7±14.5 years. The mean ASAS-HI score in all patients was 4.7±4.0, showing a “strong” positive linear correlation (r>0.60) with BASDAI and BASFI, and “moderate” positive (r=0.40 to 0.60) with Global VAS and ASDAS (Figure 1). Patients with fibromyalgia showed a significantly higher ASAS-HI score compared with patients without fibromyalgia (9.5±3.2 vs 3.7±3.4, respectively). In addition, patients with high disease activity (ASDAS>2,1) showed a higher mean score in ASAS-HI compared with those with low activity (ASDAS≤2,1) (5.8 ± 3.8 vs 2.0 ± 2.4, p Finally, multiple linear regression showed that 57,4% (R2=0,574) of the ASAS-HI variability is explained by the presence of concomitant fibromyalgia (β = 2.23, 95%IC 0.73 to 3.80, p=0.004), BASDAI (β = 0.62, 95%IC 0.25 to 0.97, p=0.001) and BASFI (β = 0.57, 95%IC 0.26 to 0.88, p=0.001). Conclusion: In our study, the impairment of the quality of life in patients with SpA was mainly associated with a high disease activity (BASDAI), worsening functionality (BASFI) and with the presence of concomitant fibromyalgia. Neither mSASSS nor UCOASMI was associated with a change in ASAS-HI; thus, in our patients neither structural damage nor mobility seem to influence the quality of life. In a patient with a high ASAS-HI we must evaluate the presence of concomitant fibromyalgia. Acknowledgments: The authors wish to thank all patients who participated in the study. Disclosure of Interests: Maria Angeles Puche Larrubia: None declared, Clementina Lopez-Medina: None declared, Maria del Carmen Castro Villegas: None declared, Rafaela Ortega Castro: None declared, MLourdes Ladehesa Pineda: None declared, Perez Sanchez Laura: None declared, Gomez Garcia Ignacio: None declared, Jose Miguel Sequi-Sabater: None declared, Maria del Carmen Abalos-Aguilera: None declared, Inmaculada Concepcion Aranda-Valera: None declared, Garrido Castro Juan Luis: None declared, Alejandro Escudero Contreras Grant/research support from: ROCHE and Pfizer, Speakers bureau: ROCHE, Lilly, Bristol and Celgene., Eduardo Collantes-Estevez: None declared