Determinants of the patient global assessment of well-being in early axial spondyloarthritis: 5-year longitudinal data from the DESIR cohort

Fumio Hirano, D. sirée van der Heijde, Floris A. van Gaalen, Robert B. M. Landewé, C. cile Gaujoux-Viala, Sofia Ramiro

Research output: Contribution to JournalArticleAcademicpeer-review

2 Citations (Scopus)


OBJECTIVES: To investigate the determinants of patient well-being over time, and the influence of age, gender and education in patients with early axial spondyloarthritis (axSpA). METHODS: Five-year data from DESIR, a cohort of early axSpA, were analysed. The outcome was the BAS-G over 5 years. Generalized estimating equations (GEE) were used to test the relationship between potential explanatory variables from five outcome domains (disease activity, physical function, spinal mobility, structural damage and axial inflammation) and BAS-G over time. Longitudinal relationships were analysed using an autoregressive GEE model. Age, gender and educational level were tested as effect modifiers or confounders. RESULTS: A total of 708 patients were included. Higher BASDAI questions on fatigue [β (95% CI): 0.17 (0.13, 0.22)], back pain [0.51 (0.46, 0.56)], peripheral joint pain [0.08 (0.04, 0.12)] and severity of morning stiffness [0.08 (0.03-0.13)], and higher BASFI [0.14 (0.08, 0.19)] were associated with a higher BAS-G. In the autoregressive model, the same variables except for morning stiffness were associated with a worsening in BAS-G. Age, gender and educational level were neither effect modifiers nor confounders. CONCLUSION: A higher level of back pain is associated with a worsening of patient well-being, as are, though to a lesser extent, higher levels of fatigue, peripheral joint pain and physical disability. Age, gender and educational level do not have an impact on these relationships.
Original languageEnglish
Pages (from-to)316-321
Number of pages6
JournalRheumatology (Oxford, England)
Issue number1
Publication statusPublished - 1 Jan 2021


  • disability evaluation
  • outcome measures
  • patient attitude to health
  • quality of life
  • spondyloarthritis

Cite this