LAUSR

Background Life quality issues in spondyloarthritis (SPA) are often spontanously mentioned by patients or identified by rheumatologists. Besides classic follow up parameters, we have to consider those issues to improve our patients life quality. Objectives Explore and quantify the impact of SPA on life quality via everyday’s life and psychological items and the effect of treatment on them. Methods SPA cases were collected by a group of 14 private practice rheumatologists (Rh) in the Paris area. Basic informations about the patient and his disease were provided by his rheumatologist. Questionnaire including 12 themes and 41 items was filled in by the patient. Results 50 cases collected, 59.5% men, mean age 45 years, 82% working Axial SPA 42%, peripheric 4%, mixt 52%. Mean duration before study: 14 years. Moderate disease 57%, severe 26,5%. HLA B27 positive 84% Drugs: NSAIDS 96%, classic DMARDS 31%, biological DMARDS 84%, corticosteroids 36%, combination therapy 42%. Associated measures were suggested by the Rh: Physical activity (62%), rest (56%), psychological support, physiotherapy, yoga, adapting professionnel activity and environment… Life quality issues are spontaneously mentioned by 40% of the patients. Before treatment, 72% of the patients report consequences on their hobbies, 68% on their psychological well-being, 54% on their getting about, 50% on their family relations. The less impacted items are food (26%) and economy (24%). Life quality is mostly altered by pain (71%), then fatigue (17%), handicap (7%) and other people’s attitude (5%). After treatment, social repercussions diminish by 47%, then getting about, housework, family relations, holidays, sexual life, psychological well-being, hobbies and work (between −21% and −44%). Drug intolerance: 36%. The items improving by more than 50% after treatment are in this order: cultural life, transports, house-keeping, do-it-yourself, sleep, going out, work (53% less sick leave). The treatment is less efficient (<22%) on economy, dependance, disillusion, depression and sexual life. Family circle lacks empathy in 66% of the cases, family relations stay difficult after treatment. Conclusions SPA diminishes quality of life in 75% of our patients, but only 40% mention it spontaneously. All the parameters impacted by SPA were significantly improved after treatment. The best improvement concerned hobbies, including culture, do-it-yourself and going out. One patient of two found correct sleep and felt psychologically better. Sick leave was reduced by half, but, unfortunately, family relations didn’t improve. The rheumatologist has to track, in a trusting patient-physician relation, the daily situation impacted by the SPA. Disclosure of Interest None declared