Pain and Function Mediate Association Between Stiffness and Quality of Life in axSpA

Increased stiffness and pain in addition to reduced function were associated with poor quality of life in patients with axial spondyloarthritis (axSpA), according to study results published in Seminars in Arthritis and Rheumatism.

Researchers analyzed cross-sectional data from 221 patients with axSpA from the Precision Medicine in Spondyloarthritis for Better Outcomes and Disease Remission (PRESPOND) registry in Singapore from 2011 to 2018. The team collected information on patient demographics, patient-reported outcome measures, and other clinical parameters. Subsequently, the relationship of stiffness, pain and function, and quality of life was evaluated using path analysis.

After analysis, the researchers observed relationships between stiffness and pain, pain and function, pain and quality of life, and function and quality of life (P <.001 for all). In addition, function was directly linked to quality of life, while stiffness was linked to quality of life through both function and pain.

One key limitation of the analysis was the cross-sectional design of the study.

“Current treatment algorithms do not specify how to treat stiffness specifically, even though stiffness is used as a surrogate marker of disease activity and disease flare,” the researchers wrote.

“Physiotherapy, exercise and pain medications should all be part of the treatment plan to improve the [quality of life] among patients with stiffness in axSpA,” they concluded.

Reference

Kwan YH, Fong W, Cheng GHL, et al. The mediating role of pain and function in the association between stiffness and quality of life in patients with axial spondyloarthritis [published online March 2, 2019]. Semin Arthritis Rheum. doi:10.1016/j.semarthrit.2019.02.010