FRI0199 Functioning categories by asas health index in patients with active ankylosing spondylitis and concomitant fibromyalgia
Authors: I. Shapoval, M. Stanislavchuk, L. Perebetiuk, G. Movchan
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Ankylosing spondylitis (AS) is a chronic rheumatic disease that characterised by prevalent inflammatory spinal involvement. Concomitant fibromyalgia (FM) can significantly modify this condition. In 2014, ASAS Health Index and Environmental Factors (ASAS HI/EF) appeared as new tool to assess the health status of patients with spondyloarthritis, able to describe the total impairments, restrictions and functional limitation due to AS.<sup><sup>1</sup></sup> <h3>Objectives</h3> The aim of this study was to evaluate the functional status of patients with active AS with concomitant FM by the functioning categories of ASAS HI. <h3>Methods</h3> The study included 72 patients with AS according to the modified. New York criteria (1984) Fifty-nine were male (81.94%), average age 39.5±11.72 (M±SD) years. FM was diagnosed by modified criteria of the American College of Rheumatology (2010) The disease activity we assessed by Ankylosing Spondylitis Disease Activity Score (ASDAS-ESR). We used Ukrainian version of ASAS HI/EF.<sup>2</sup> Functional categories were established as recommended.<sup>3</sup> We categorised patients into 3 functioning categories: normal functioning (ASAS HI ≤4), moderate impairment of functioning (&gt;4 and≤8) and severe impairment of functioning (ASAS HI &gt;8). <h3>Results</h3> Twenty patients met the criteria for FM (27.78%). Disease activity according to the ASDAS-ESR in patients with AS and AS with concomitant FM was almost the same: 3.58±0.84 and 3.98±0.91. However, ASAS HI in patients with AS and FM was significantly higher than in patients with AS (7.3±1.22 vs. 5.8±1.84). According to ASAS HI we divided all patients into functioning categories. 10 of 52 patients with AS (19.23%) had normal functioning, 39 (75%) were classified as patients with moderate impairment of functioning and 3 (5.77%) had severe impairment of functioning. In the group AS +FM patients with normal function were not found, while others were distributed in a ratio of 2:1–13 (65%) patients with moderate and 7 (35%) with severe impairment of functioning. It was revealed relationship between ASAS HI and disease activity (r=0.549). <h3>Conclusions</h3> Concomitant FM impairs the functional status in patients with AS. High and very high disease activity in patients with AS is associated with functional disability according to ASAS HI functioning categories. ASAS HI is reliable and sensitive clinical tool for determining impairment of functioning in patients with AS. <h3>References</h3> [1] Kiltz U, van der Heijde D, Boonen A, Braun J. The ASAS Health Index (ASAS HI)–a new tool to assess the health status of patients with spondyloarthritis. Clin Exp Rheumatol2014;32(Suppl 85):105–8. [2] Stanislavchuk MA, Shapoval II, Zaichko KO. Adaptation and validation Ukrainian version of ASAS Health Index and Environmental Factors in patients with ankylosing spondylitis. Ukrainian Journal of Rheumatology2016;3(65):55–58. [3] Di Carlo M, Lato V, Di Matteo A, Carotti M, Salaffi F. Defining functioning categories in axial spondyloarthritis: The role of the ASAS Health Index. Rheumatology international2017;37(5):713–718. <h3>Disclosure of Interest</h3> None declared