Navigating the Factors Affecting Functional impairment in Spondyloarthritis

Objectives: To assess the predictive factors of functional impairment in SpA patients assessed with BASFI (Bath Ankylosing Spondylitis Functional Index) and LI (Lequesne Index). Methods: We conducted a retrospective study that included SpA patients. Socio-demographics and disease-related data were reported (data collection spread over four months from August 2019 to November 2019). Disease activity was assessed using the Bath Ankylosing Spondylitis-Global score (BASG-s) and the Bath Ankylosing Spondylitis disease activity Index (BASDAI). The spinal mobility was evaluated by The Bath Ankylosing Spondylitis Metrology Index (BASMI). Structural progression was evaluated with The Bath Ankylosing Spondylitis Radiologic Index (BASRI) and modified Stoke ankylosing spondylitis spine score (mSASSS). We conducted a multivariate analysis to search for predictive factors associated with BASFI and LI. Significance was accepted for a p < 0.05 for all statistical tests. Results: Two hundred and sixty-three patients were included. Mean age of the patients was 38.9 ±12.7 years, sex-ratio=2.7. Mean age of onset of SpA was 27.6 ± 10.8. Disease duration was 11.3 ±9.5 years. Occupation was significantly associated with BASFI score and LI. A significant functional impact was significantly correlated with a long duration of the disease. The two scores were correlated with a limitation of spinal mobility (BASMI), a greater disease activity (BASDAI and ESR) and a greater impact of the disease on health status (BASG-s). Significant functional impairment was also correlated with structural impairment: mSASSS, BASRI and sacroiliitis grade. The variables independently related to BASFI were the mSASSS score and the BASDAI. The variables independently related to LI were the profession (unemployed subjects had higher scores), mSASSS score, and the BASMI. Conclusion: Occupation, disease activity, mobility and structural progression predicted functional impairment in Tunisian SpA patients. Keywords: Spondyloarthritis; North Africa; Function; Impairment.