Objective:

To evaluate functional deterioration and work disability in men and women with spondyloarthritis over a 17-year period.

Approach:

• Study Design: A longitudinal observational study involving 271 men and 140 women with spondyloarthritis from the REGISPONSER registry, with assessments from 2004 to 2007 and follow-up from 2021 to 2024.
• Data Collection: Clinical information was collected retrospectively through standardized medical record reviews and structured follow-up interviews.
• Assessment Tools: Functional ability was evaluated using the Bath Ankylosing Spondylitis Functional Index (BASFI) and disease activity with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).
• Statistical Analysis: Sex-stratified univariable and multivariable logistic regression analyses were performed to identify factors associated with permanent disability and changes in BASFI.

Key Findings:

• Women experienced greater functional deterioration (mean BASFI change of 1.4) compared to men (mean BASFI change of 0.3).
• Permanent work disability was reported in 27% of women and 32% of men, with no statistically significant difference.
• Higher baseline BASDAI and BASRI scores were associated with permanent disability in both sexes.
• The relationship between systemic inflammation and long-term functional outcomes differed by sex.

Limitations:

• Clinical heterogeneity due to multiple spondyloarthritis subtypes.
• Instruments used may have limited applicability for peripheral-predominant phenotypes.
• Baseline data did not capture fibromyalgia, depressive symptoms, or other psychosocial comorbidities.
• Absence of prospective intermediate assessments limited evaluation of changes in disease activity and treatment response.
• Potential attrition or survivor bias due to the long follow-up period.

Sources:

• RMD Open