Patients with well-established ankylosing spondylitis show limited deterioration in a ten-year prospective cohort study

Healey, E. L.; Haywood, K. L.; Jordan, K. P.; Garratt, A. M.; Packham, J. C.

Abstract

This study aims to describe the deterioration of well-established ankylosing spondylitis (AS) over a 10-year period. Patients with well-established AS under secondary care review were assessed at baseline and re-assessed after a 10-year period. Data on patient characteristics, spinal mobility and self-reported health status (AS Quality of Life, Bath AS Disease Activity Index, EuroQoL, Revised Leeds Disability Questionnaire and Short Form-12) were compared between the two time points. One hundred fifty-nine patients took part in the initial assessment. After 10 years, 69/117 patients still under secondary care follow-up attended a second assessment. At the second assessment, this cohort was predominately male (92.8 %), mean age of 48.7 years (SD 9.7) and mean disease and symptom duration of 14.9 (SD 9.0) and 21.9 years (SD 13.3), respectively. Amongst the physical and patient-reported measures, only tragus to wall (p < 0.001), cervical rotation (p = 0.001) and disability (p = 0.02) had significantly deteriorated over time. The percentage of patients who had withdrawn from the workforce before normal retirement age increased from 37 to 53 % over the 10-year period. Many of the measures used in the assessment of AS do not generally deteriorate over time in those with well-established disease. This suggests that deterioration may plateau in established disease. However, AS has a long-term social impact with levels of employment in this cohort 30 % lower than the general population. Interventions directed at preventing deterioration may be more effective earlier in their disease course, before this plateau is reached.

Citation

Healey, E. L., Haywood, K. L., Jordan, K. P., Garratt, A. M., & Packham, J. C. (2013). Patients with well-established ankylosing spondylitis show limited deterioration in a ten-year prospective cohort study. Clinical Rheumatology, 32(1), 67-72. https://doi.org/10.1007/s10067-012-2092-3

• Journal Article Type: Article
• Acceptance Date: Sep 12, 2012
• Online Publication Date: Sep 27, 2012
• Publication Date: 2013-01
• Deposit Date: Sep 19, 2023
• Journal: CLINICAL RHEUMATOLOGY
• Print ISSN: 0770-3198
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 1
• Pages: 67-72
• DOI: https://doi.org/10.1007/s10067-012-2092-3