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.
