Ab0998 differences in psychological burden and in quality of life measures between genders in spondyloarthritis patients-analysis of a monocentric cohort

Background Spondyloarthropathies (SpA) are chronic inflammatory arthritis, characterized by both peripheral and axial skeletal involvement and some typical extra-articular marks; they tend to associate with several comorbidities and can increase the risk of an impaired quality of life (QoL). Already published data show SpA expression differs based on gender; in particular, women are at higher risk of a more pronounced peripheral disease activity and show a greater burden of the disease, thus having worse values of Patient Reported Outcomes (PROs). It is well known that a compromission in physical functioning and psychological sphere may compromise productivity of patients and subsequently increase health costs. Objectives The aim of our study was to assess the differences between male and female sex in the prevalence of mood disorders, fatigue and parameters of QoL in a monocentric cohort of patients with SpA. Methods Adult patients diagnosed with Psoriatic Arthritis (PsA) and Ankylosing Spondylitis (AS) according to the CASPAR (ClASsification criteria for Psoriatic Arthritis) and to Assessment of SpondyloArthritis international Society (ASAS) criteria, regularly followed at the SpA clinic of our unit, were consecutively enrolled from April to December 2022. Epidemiologic, clinic and clinimetric data were collected. Each patient filled in the following Patient Reported Outcomes: Hospital Anxiety and Depression Scale (HADS), FACIT-Fatigue (FACIT-F) and SHORT-FORM 36 (SF-36). Intergroups comparisons were assessed by using Chi-square, t-test and ANOVA. P values <0.05 were considered significant. Results A total of 200 patients were enrolled; 85 (42.5%) were women, with a mean age of 56.84±12.22 years and a mean disease duration of 12.91±10.3 years. One hundred and thirty-five patients (67.5%) had a diagnosis of PsA (M/F 79/56), while 59 (29.5%) had a diagnosis of AS (M/F 36/23) and 6 (3%) of Enteropathic Arthritis (M/F 0/6). Women showed worse FACIT-F values than men, (mean 35.20 vs 40.23, p-value 0.002) and a greater impairment of QoL expressed by statistically significant lower values of almost all the domains of SF-36 (exception for Global Health). Moreover, the values of HADS resulted higher in female sex both for the anxiety and depression domains (p-value <0.001 and 0.039 respectively). Conclusion The analysis of our cohort confirmed that women affected by SpA suffer from anxiety and depression more often than men, develop a higher level of fatigue and have an overall worse QoL in both psychological and physical domains. These data should sensitize rheumatologists in the assessment of this subgroup of patients. The clinician should not only focus on the disease activity evaluation and therapy or in managing of the comorbidities, but also on the psychological and functional status of the patients, developing strategies able to avoid or delay the onset of their impairment in daily life and to optimize with specific therapies, rehabilitation or psychological support their compromission, when already established. This approach could finally improve the social burden and health cost of women with SpA. Figure 1. References [1]Wright GC, Kaine J, Deodhar A. Understanding differences between men and women with axial spondyloarthritis. Semin Arthritis Rheum. 2020 Aug;50(4):687-694. doi: 10.1016/j.semarthrit.2020.05.005. Epub 2020 May 25. PMID: 32521322. [2]Swinnen TW, Westhovens R, Dankaerts W, de Vlam K. Widespread pain in axial spondyloarthritis: clinical importance and gender differences. Arthritis Res Ther. 2018 Jul 27;20(1):156. doi: 10.1186/s13075-018-1626-8. PMID: 30053895; PMCID: PMC6062924. Acknowledgements To all the dear collegues I work with. Disclosure of Interests None Declared.