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Aggressive Management Can Help Long Term Function In Ankylosing Spondylitis

Aggressive management of ankylosing spondylitis (AS) improve long-term functioning ability, say researchers.

Clinicians at the Royal National Hospital for Rheumatic Diseases, Bath, England, looked into finding predictors for long term outcome among AS patients. They assessed data on the possible factors among 311 AS patients, 252 of whom were men (81%).

Univariate statistics and multivariable linear regression analyses were used to identify factors correlated with disease outcome, which was defined in terms of radiological (Bath AS Radiology Index, BASRI) and functional status (Bath AS Functional Index, BASFI).

The clinicians found that duration, sex, and iritis are independently associated with BASRI, and that they account for 23% (p < 0.001) of variation in radiological scores (BASRI-t). This measure includes the hip joint in the score. Radiological hip involvement is significantly associated with higher scores of spinal radiological change (BASRI-s) (p < 0.001).

Independent associations which account for 50% of variability in functional status (p < 0.001) include cigarette smoking, radiological status, and Bath AS Disease Activity Index score (BASDAI).

The clinicians conclude that "much of the variability in disease severity in AS remains unexplained. All but one of the factors associated with outcome in this study are inherent. This suggests that genetic factors have a greater influence than environmental factors on radiological progression and disability in AS."

At the same time, it could be possible to improve long term functional outcome in AS by targeting high risk individuals early in the course of their disease, and institute some strategies, one of which would be to encourage any AS patients who smokes to give up the habit.
Rheumatol 2003;30:316-20. "Predictors of Longterm Outcome in Ankylosing Spondylitis"

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