| Background:As a chronic autoimmune inflammatory disease, Ankylosing Spondylitis(AS) mainly affects the axial skeleton such as spine, sacroiliac joints and the peripheral joints. It's also characterized by relatively young onset age, easily causing spinal deformity and stiffness, and seriously influencing the health related Quality of Life(QoL) and engaging heavy economical burden for the patients, their families and even the whole society. Although the QoL and disease burden of patients with AS have been a research focal in abroad, the Domestic academia hasn't paid enough attention to this issue. By literature searching, we found that there were adequate clinical studies about the Patient-reported Outcomes(PROs), which include Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), Bath Ankylosing Spondylitis Functional Index(BASFI) et al, but there were few related research data about Chinese population.This study was designed to assess the clinical value of various PROs in a prospective cohort study of AS patients, and to evaluate the medicine cost and other treatment-related cost of patients with AS, and to explore the global economical burden and the factors that may affect the cost.Methods:Part. I 517 AS patients were collected from the Department of Rheumatology, Chinese PLA General Hospital from August 2013 to September 2015. The Quality of Life (QoL) were assessed by SF-36 questionnaire and compared with the general population. The correlation between QoL and clinical measures of AS, including BASDAI, BASFI et al, were analysed. Part.? A retrospective study was performed in 205 patients with AS collected from the Department of Rheumatology, Chinese PLA General Hospital from August 2015 to January 2016. Data were obtained from the questionnaire survey and medical record review. The multivariate logistic regression analysis was performed to explore the global economical burden and influence factors.Results:Part. I BASDAI and BASFI were significantly correlated with SF-36 scores(r>0.3, P<0.01). Logistic multiple regression analysis showed that BASDAI, BASFI, BASMI and education had close correlation with the baseline global QoL, physical and mental health. BASDAI variation showed the most important influence on the change of global QoL, physical health and mental health(OR=0.235,0.209,0.125; P<0.01). Part. ? The total average medicine cost in the past year was ?17435.93 per patient, of which non-steroid anti-inflammatory drugs represented 4.2% percentages, conventional disease modifying anti-rheumatic drugs represented 11.7%, biological disease modifying anti-rheumatic drugs represented 81.9%, herbal drugs represented 2.2%. The other cost correlated with the treatment of AS were laboratory examination(?1712.00/year),transportation(?2123.51/y),accommodation(?1163. 76/y),other cost(?264.15/y). Peripheral articular involvement(OR=2.412, 95%CI:1.006-4.562, P=0.048) and disease duration(OR=0.197, 95%CI:0.056-0.693, P=0.011) showed the most important influence on the total medicine cost.Conclusion:Part. I SF-36 can objectively reflected the QoL of patients with AS. PROs such as BASDAI and BASFI showed great application value in this prospective cohort study of AS patients.Part. II High medicine cost directly increased the economical burden of AS patients. Peripheral articular involvement and disease duration showed the most important influence on the total medicine cost. Other indirect cost related with the therapies also increased the economical burden of AS patients. |
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