Health-related quality of life in patients with ankylosing spondylitis: a comprehensive review

Abstract

Ankylosing spondylitis (AS) is a complex systemic rheumatological disease which often causes severe disability and impaired quality of life (QoL). We searched the PubMed/MEDLINE electronic database for available literature on QoL and its predictors in patients with AS. Recent evidence indicates that AS patients have poorer QoL compared to the general population, but similar to that of patients with other rheumatological disorders. Disease activity is one of the most powerful predictors of QoL, however latest advances in pharmacological treatment (namely, anti-TNF-α) along with physical exercise can minimize the effects of AS on QoL. Psychological distress symptoms contribute to impaired QoL both directly and indirectly by influencing disease activity. The impact of other psychosocial variables, however, is less studied and more prospective investigations are necessary, which could eventually lead to the development of psychosocial interventions that are personalized to this patient population.

Keywords::

• ankylosing spondylitis
• anxiety
• depression
• disease activity
• functional limitations
• illness perceptions
• quality of life

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript

Key issues

• Ankylosing spondylitis (AS) is a chronic disease that often causes severe disability.

• Quality of life (QoL), especially physical and mental QoL, is impaired in AS compared with the general population and is comparable to QoL of patients with other rheumatological disorders.

• The effect of AS on working capacity is substantial.

• New drug treatments and physical exercise are beneficial to AS patients’ QoL.

• Disease activity is one of the most powerful predictors of QoL.

• Psychological distress can affect QoL, but the impact of other psychological variables on AS patients’ QoL needs further study.