Health-Related Quality of Life in Early Arthritis, Inflammatory Back Pain

nurse talking to patient
nurse talking to patient
Researchers posit that improvement of health related quality of life should be an objectives of treatment of early arthritis and early inflammatory back pain, but their finding is that disease only explains part of the assessment of quality of life.

Patients with early arthritis (EA) and early inflammatory back pain (IBP) have similar changes in health-related quality of life (HRQoL), but not all of it is explained by disease activity, according to results published in Arthritis Research & Therapy.

The study included participants from 2 prospective observational French cohorts, 1 of EA participants and 1 of early IBP participants. Over the course of 5 to 8 years, participants’ HRQoL was regularly assessed, using the 36-Item Short Form Survey physical and mental composite scores (PCS and MCS, range 0-100). The researchers used the 28-joint Disease Activity Score based on erythrocyte sedimentation rate (DAS28-ESR) and Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP) to assess disease activity.

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A total of 1347 participants were analyzed, including 701 with EA and 646 with early IBP. The mean age was 48.4±12.2 years for EA and 33.9±8.7 for IBP; mean disease duration was 3.4±1.7 months and 18.2±10.8 months, respectively.

At baseline, participants with EA had mean PCS of 40.2±9.1 and a mean MCS of 40.4±11.2. Among participants with early IBP, mean PCS was 38.5±8.5 and mean MCS was 39.8±10.9.

During follow-up, the researchers found that mean HRQoL levels increased mostly during the first 6 months (P <.001). They noted 2 distinct trajectories in both groups, with 1 trajectory corresponding closely to HRQoL in the general population (trajectory A) and the other with a more altered HRQoL (trajectory B).

Among participants with EA, from 57.2% to 60.8% were in trajectory A compared with 54.2% to 58.4% of those with EA.

The results indicated that DAS28-ESR and ASDAS-CRP over time were linked to PCS (range of explained variance, 9%-43%; P <.001), but not to MCS.

“The drivers of HRQoL in inflammatory rheumatic disorders and specifically the links with disease activity should be further explored,” the researchers wrote.


Puyraimond-Zemmour D, Granger B, Molto A, et al. Similar alteration for mental and physical aspects in health-related quality of life over 5 to 8 years in 1347 patients with early arthritis and early inflammatory back pain [published online February 19, 2019]. Arthritis Res Ther. doi: 10.1186/s13075-019-1841-y