THU0381 PATIENT-REPORTED IMPACT OF AXIAL SPONDYLOARTHRITIS ON WORKING LIFE: RESULTS FROM THE EMAS SURVEY
Authors: Marco Garrido-Cumbrera, Laure Gossec, Victoria Navarro-Compán, David Gálvez-Ruiz, Christine Bundy, Raj Mahapatra, Souzi Makri, Sergio Sanz-Gómez, Carlos Delgado Domínguez, Denis Poddubnyy
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Axial spondyloarthritis (axSpA) impacts multiple dimensions of patients’ lives, including working life. <h3>Objectives:</h3> To evaluate work-related issues, their associations and determinants among European axSpA patients. <h3>Methods:</h3> The European Map of Axial Spondyloarthritis (EMAS), conducted from July 2017 to February 2018, was a cross-sectional on-line survey of unselected patients with self-reported axSpA from Austria, Belgium, France, Germany, Italy, Netherlands, Norway, Russia, Slovenia, Spain, Sweden, Switzerland, and the UK. Participants were recruited through an on-line panel and patient organizations. Participants were classified as active (employed, unemployed between 15-64 years) or inactive (retirees, on sick leave, students and homemakers). Those employed were asked to report work-related issues (sick-leave, difficulty fulfilling work hours, missing work for doctors’ appointments, reducing working hours or taking days off) in the past 12 months. Disease activity (BASDAI), self-reported spinal stiffness, diagnostic delay and psychological distress (General Health Questionnaire, GHQ-12) were compared between employed patients with or without work-related issues using a Mann-Whitney and Kruskal-Wallis test. Two-stage regression analysis was conducted to determine explicative sociodemographic (using stepwise method for income, age, gender, education) and disease-related factors (enter method for BASDAI, self-reported spinal stiffness, functional limitation) over work-related issues. <h3>Results:</h3> 2846 axSpA patients participated in EMAS: mean age was 44±12 years, 61.3% were female and 48.1% were university educated. Mean disease duration and diagnostic delay were 17.2±12.4 and 7.4±8.4 years, respectively, and mean BASDAI was 5.5±2.0. 61.3% (n=1653) were considered active, of which 87.7% (n=1450) were employed. Of those employed, 67.7% reported a work-related issue, specifically 56.3% took sick leave, 44.6% had difficulties in fulfilling the working hours, 34.6% missed work due to doctor’s appointments, 31.6% requested days off, and 25.7% reduced their number of working hours (Table 1). Among all patients, 74.1% faced or believed they would face difficulties finding a job due to axSpA. Experiencing work-related issues due to axSpA was significantly associated with higher disease activity, self-reported spinal stiffness, longer diagnostic delay, and higher level of psychological distress (p&lt;0.001). First regression step showed gender and educational level as explanatory sociodemographic control factors, while educational level and BASDAI were the only statistically significant explanatory factors in the second step (p≤0.001) (Table 2). <h3>Conclusion:</h3> Nearly two-thirds of employed patients experienced work-related issues due to axSpA. The strongest factor associated with work-related issues was high disease activity. Understanding the determinants of work-related issues is needed to ensure that patients have adequate workplace and holistic medical support to lead productive work-lives <h3>Acknowledgement:</h3> EMAS was funded by Novartis Pharma AG <h3>Disclosure of Interests:</h3> Marco Garrido-Cumbrera Consultant for: Honoraria from Novartis as steering committe of this survey, Laure Gossec Grant/research support from: AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis-Sandoz, Pfizer, Sanofi, and UCB, Consultant for: AbbVie, Biogen, BMS, Celgene, Janssen, Lilly, MSD, Nordic Pharma, Novartis-Sandoz, Pfizer, Roche, Sanofi, and UCB, Consultant for: L Gossec has received honoraria from Celgene as investigator for this study, Victoria Navarro-Compán: None declared, David Gálvez-Ruiz Consultant for: Honoraria from Novartis as steering committe of this survey, Christine Bundy Consultant for: Honoraria from Novartis as steering committe of this survey, Raj Mahapatra Consultant for: Honoraria from Novartis as steering committe of this survey, Souzi Makri: None declared, Sergio Sanz-Gómez: None declared, Carlos Delgado Domínguez Consultant for: Honoraria from Novartis as steering committe of this survey, Denis Poddubnyy Grant/research support from: AbbVie, Merck Sharp &amp; Dohme, Novartis, Consultant for: AbbVie, Bristol-Myers Squibb, Janssen, Merck Sharp &amp; Dohme, Novartis, Pfizer, UCB Pharma, Speakers bureau: AbbVie, Bristol-Myers Squibb, Janssen, Merck Sharp &amp; Dohme, Novartis, Pfizer, Roche, UCB Pharma