Abstract
Objective Axial spondyloarthritis (axSpA) may have an impact on work. The Ankylosing Spondylitis Work Instability Scale (AS-WIS) assesses difficulties at work. The objective of this study was to evaluate the predictive value of the AS WIS on work impact.
Methods Prospective cohort study with two timepoints (at baseline and after 1.5 years) including patients with axSpA and a paid professional activity. Patients completed the AS-WIS at baseline and work instability was scored as moderate/high if ≥11 (0-20 scale). At follow up, adverse work outcomes (AWO) were defined as short-term sick leave or severe AWO (long-term sick leave, disability, unemployment). Univariable and multivariable logistic regression analyses were performed to explain AWO.
Results Of 101 patients, mean age 45 (standard deviation (SD) 9) years, 52% male, disease duration was 14 (SD 8) years. The BASDAI and the BASFI were respectively 34 (SD 21) and 23 (SD 23), 69 (68%) received a TNF-inhibitor. At baseline, 46 (46%) patients had moderate/high AS-WIS. At 1.5 years of follow-up, 37 patients (36%) had AWO: 25 patients (25%) a short-term sick leave, and 12 patients (12%, 7/100 patient years) a severe AWO. Independent baseline factors associated with AWO were a moderate/high AS-WIS score (odds ratio 2.71 [95% confidence interval 1.04-7.22]) and shorter disease duration (0.94 [0.89-0.99]).
Conclusion In patients with axSpA, a moderate/high AS-WIS score was predictive of AWO in this population with well-controlled axSpA. This short questionnaire can be helpful to screen for future difficulties at work.
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