POS0662 THE SOCIOECONOMIC PROFILE OF PATIENTS WITH RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS IS ASSOCIATED WITH THE SEVERITY OF THE DISEASE AND WITH THE PERMANENT DISABILITY. A CLUSTER ANALYSIS IN A NATIONAL SPANISH REGISTRY

• Published in: Annals of the rheumatic diseases Vol. 82; no. Suppl 1; pp. 610 - 611
• Main Authors: López-Medina, C, Ruiz, D, M Á Puche Larrubia, Ladehesa Pineda, M L, Ábalos-Aguilera, M C, Pilar, F U, A Escudero Contreras, E Collantes Estevez
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2023
• Subjects: Ankylosing spondylitis; Arthritis; Body mass index; Cluster analysis; Diagnosis; Employment; Gender; Housing; Housing conditions; Inflammatory diseases; Patients; Rheumatic diseases; Socioeconomic factors
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2023-eular.536

BackgroundPrevious studies have demonstrated that male gender and higher level of education are independently associated with a lower hazard of sick leave in patients with axial Spondyloarthritis (axSpA), while female gender has a disadvantageous effect on employment. However, few studies have identified socio-economic profiles of patients and their association with the severity of the disease and disability.Objectivesa) to identify clusters of patients with r-axSpA according to their socio-economic characteristics; b) to evaluate the association of these clusters with the severity of the disease and permanent disability.MethodsREGISPONSER (Spanish Registry of Spondyloarthritis) was a cross-sectional and multicentre study including Spanish patients with spondyloarthritis (SpA) according to the ESSG criteria. Patients considered by their treating rheumatologist as suffering from radiographic axSpA (r-axSpA) or ankylosing spondylitis (AS) were included in this specific analysis. A cluster analysis was conducted using information on sociodemographic (age, sex, race, marital status, education) and socioeconomic characteristics (employment, profession, housing conditions and social level). Multiple correspondence analyses and k-means clustering methods were used. The clinical characteristics, burden of the disease and permanent disability were compared between the different clusters adjusting for disease duration.ResultsA total of 866 patients with r-axSpA were included in the analysis. Two clusters were found according to the socio-economic characteristics (Table 1). Cluster 1 (n=476) showed a profile of patients predominantly married, with secondary/elementary studies, unemployed/housekeepers, nonskilled workers, with good or deficient housing conditions and low-middle social level. On the other hand, cluster 2 (n=479) showed a profile of patients with predominantly university/bachelor studies, employed, with university/technician professions, optimal housing conditions and upper-middle social level.In terms of clinical characteristics and burden of the disease, after adjusting for disease duration, patients from cluster 1 showed older age at the diagnosis (37.9 vs. 32.6), a longer diagnosis delay (7.8 vs. 6.8 years), higher body mass index (27.6 vs. 25.9) and greater structural damage in comparison with cluster 2 (BASRI total (5.7 vs. 4.6) and BASRI cervical (6.9 vs. 5.7)). No differences were found regarding smoking, peripheral and extra-musculoskeletal manifestations.The access to biologic modified antirheumatic drugs (bDMARDs) was similar between the two groups (30.6% vs. 27.5%, p=0.376, for cluster 1 and 2, respectively). However, patients from cluster 1 showed a higher prevalence of permanent disability in comparison with cluster 2 after adjusting for disease duration [30.8% vs. 13.2%, OR 2.58 (95%CI 1.76 - 3.83), p<0.001].ConclusionThis study suggests that the socio-economic profile of patients with r-axSpA may have implications in the severity of the disease and in permanent disability despite a similar use of bDMARDs.Table 1.Comparison of the socioeconomic characteristics between the two clusters.Cluster 1 N = 476Cluster 2 N = 390Sex male vs. Female75.2%74.1%Race white vs. Others98.5%99.7%Married vs. single/ divorced/ widowed81.5%71.0%University/ bachelor studies vs. secondary/ elementary studies/ illiterate4.4%73.1%Employed/ retired vs. unemployed/ housekeeper51.0%67.4%University/ technician profession vs. employee/ skilled/ nonskilled worker0.4%49.0%Luxury/ optimal housing conditions vs. good/ deficient/ inadequate27.9%65.9%Upper/ Upper-middle/ middle social level vs. low-middle/ underclass8.4%99.5%REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsClementina López-Medina Speakers bureau: UCB, Eli Lilly, Abbvie, Janssen, Novartis and MSD, Consultant of: Eli Lilly, Novartis and Eli Lilly, Grant/research support from: UCB, Abbvie and Eli Lilly, Desiree Ruiz: None declared, María Ángeles Puche Larrubia: None declared, María Lourdes Ladehesa Pineda: None declared, M. Carmen Ábalos-Aguilera: None declared, Font Ugalde Pilar: None declared, Alejandro Escudero Contreras Speakers bureau: Galapagos, Abbvie and Eli Lilly, Eduardo Collantes Estevez Speakers bureau: Eli Lilly and Novartis, Consultant of: Eli Lilly, Grant/research support from: UCB, Abbvie and Eli Lilly.