Influence of Environmental Factors on Disease Activity in Spondyloarthritis: A Prospective Cohort Study
| Autor: | Roula Said Nahal, Maxime Breban, Jean François Vibert, Pierre Yves Boelle, Antoine Flahault, Thomas Hanslik, Emmanuelle Durand, Clément Turbelin, Alfred Mahr, Maria Antonietta D'agostino, Nadine Zeboulon-Ktorza, Homa Madrakian, Odile Launay |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Questionnaires medicine.medical_specialty Settore MED/16 - REUMATOLOGIA Epidemiology Immunology Pain Environment Stress Severity of Illness Index Life Change Events Disease activity Diagnostic Self Evaluation Rheumatology Surveys and Questionnaires Stress Psychological/*physiopathology Internal medicine Spondyloarthritis Spondylarthritis Humans Immunology and Allergy Medicine Prospective Studies Prospective cohort study BASDAI Generalized estimating equation Spondylarthritis/*physiopathology Pain Measurement Environmental Exposure Ankylosing spondylitis business.industry Repeated measures design Middle Aged medicine.disease Cohort Physical therapy Psychological Female Pain/physiopathology Life-change events BASFI business Stress Psychological |
| Zdroj: | Journal of Rheumatology, Vol. 40, No 4 (2013) pp. 469-75 |
| ISSN: | 1499-2752 0315-162X |
| DOI: | 10.3899/jrheum.121081 |
| Popis: | Objective.Spondyloarthritis (SpA) is a complex inflammatory disorder. We investigated the influence of environmental factors on SpA disease activity.Methods.A prospective cohort of adults with SpA was followed for 3 years. Patients logged on to a secured Website every 3 months to complete a questionnaire. They reported whether they had been exposed to environmental factors such as stressful or traumatic life events, infections, or vaccinations. Outcome variables included the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), and pain and patient global assessment (PGA) on visual numerical scales (each rated 0–10). Analyses were performed using a generalized estimating equation for repeated measures, adjusted for the outcome variable collected by the previous questionnaire.Results.In total, 272 patients were included in the analysis, completing the questionnaire on 2240 occasions. The average time (mean ± SD) between 2 connections to the Website was 4.0 ± 2.0 months. Occurrence of life events was followed by an increase of 0.5 (95% CI 0.4–0.7) in the BASDAI, 0.5 (95% CI 0.3–0.6) in the BASFI, 0.7 (95% CI 0.5–0.9) in the PGA, and 0.8 (95% CI 0.6–1.0) for pain (p < 0.0001 for all variations). A moderately statistically significant link was found between vaccination and an elevation of the BASDAI of 0.3 (95% CI 0.0–0.5; p = 0.032). No influence of other factors was detected.Conclusion.This prospective study in a dedicated SpA cohort shows for the first time a link between stressful events and disease activity. Although this link was statistically highly significant, its clinical meaning remains to be determined because the average magnitude of variation of the different variables studied was rather mild. |
| Databáze: | OpenAIRE |
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