Socioeconomics and Sex Affect Function in axSpA

Investigators who assessed a large sample of patients with axial spondyloarthritis (axSpA) found that those with lower socioeconomic status had worse functional status and suffered greater functional decline. In addition, women had worse functional status than men.

In their study, published in Arthritis Care and Research, the authors performed cross-sectional and longitudinal analyses of functional status of patients with axSpA in the Rheumatology Informatics System for Effectiveness registry through the Multidimensional Health Assessment Questionnaire (MDHAQ).

The cross-sectional analysis tested for a linear trend across ADI quintiles for MDHAQ. The longitudinal analysis’ outcome was functional decline. We reported predictive margins and assessed for interaction with sex. In the longitudinal analysis, we reported odds of functional decline.

In the cross-sectional analysis of 5658 patients, the mean age was 53.8; 55.8% were women and 71.4% were non-Hispanic White. The mean MDHAQ scores were 1.6 in men versus 2.1 in women. Predicted mean MDHAQ scores were 2.2 for the lowest ADI quintile (95% confidence interval [CI] 1.8–2.7) and 1.8 for the highest (95% CI 1.4–2.1).

Across quintiles women consistently showed lower functional status than men. In the longitudinal analysis of 2341 patients, 14.3% showed a decline in functional status for the lowest socioeconomic quintile (95% CI 7.6–25.5%) compared to 9.6% for the highest (95% CI 5.2–17.1%). Women had 1.7 times higher odds of functional decline compared to men (95% CI 1.3–2.2).

Stovall R, Li J,  Fitzpatrick J, et al. Low socioeconomic status and female sex are associated with worse functional status in axial spondyloarthritis. Arthritis Care Res. Published online September 18, 2024.  https://doi.org/10.1002/acr.25436