To assess the extent to which a history of extra-spinal symptoms (including peripheral arthritis, heel enthesitis, or dactylitis) (HPED) is associated with quality of life (QoL) in patients with axial spondyloarthritis (axSpA) at baseline and 1-year follow-up. We analyzed data from 138 patients with axSpA from a tertiary referral center in Singapore, seen between 2011 and 2015. Demographic, clinical variables, and patient-reported outcomes [Ankylosing Spondylitis Quality of Life (ASQoL) and SF-36] at baseline and 1-year follow-up were collected. We used linear mixed models to assess the association of HPED with QoL at baseline and 1 year post-baseline. Among 138 patients (mean age 39.3 years, 74.6% males, 87.6% Chinese, disease duration 7.4 years), at baseline, HPED was associated with poorer QoL for 3 of 8 SF-36 domains [role physical (RP) scores β - 8.38, p < 0.05; social functioning (SF) scores β - 6.74, p < 0.05; role emotional (RE) scores β - 9.37, p < 0.01] and SF-36 Physical Component Summary (PCS) (β - 4.52, p < 0.01) scores, but not ASQoL scores. At 1 year post-baseline, HPED was associated with poorer ASQoL (β 1.61, p < 0.05) scores, SF-36 PCS (β - 5.61, p < 0.01) scores, and three out of eight SF-36 domains (physical functioning (PF) β - 9.60, p < 0.01; RP β - 12.17, p < 0.01; RE β - 7.87, p < 0.05) scores. HPED was associated with QoL in patients with axSpA. After 1-year, patients with HPED have poorer QoL especially for physical health domains than patients without HPED.
Keywords: Dactylitis; Extra-spinal symptoms; Heel enthesitis; Peripheral arthritis; Quality of life; Spondyloarthritis.