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Quality of life and therapeutic management of axial spondyloarthritis patients in Italy: a 12-month prospective observational study

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24


  1. Rheumatology Department of Lucania, San Carlo Hospital of Potenza, Italy.
  2. Centro Reumatologia, AOU Sant'Orsola Malpighi di Bologna, Italy.
  3. UOSD Reumatologia, IRCCS Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy.
  4. Azienda USL-IRCCS di Reggio Emilia and Università di Modena e Reggio Emilia, Italy.
  5. Reumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy.
  6. UOSD Reumatologia, Ospedale San Giovanni Bosco, Napoli, Italy.
  7. Rheumatology Unit, Department of Medicine-DIMED, University of Padova, Italy.
  8. U.O. Reumatologia, PO V. Fazzia, Lecce, Italy.
  9. Università degli Studi di Sassari e Azienda Ospedaliero-Universitaria di Sassari, Italy.
  10. Struttura Semplice di Reumatologia, AO San Gerardo, Monza, Italy.
  11. UOS Reumatologia, AORN Cardarelli, Napoli, Italy.
  12. UO Reumatologia, AOU Arcispedale Sant'Anna di Ferrara, Italy.
  13. Rheumatology Research, Università Magna Grecia di Catanzaro, Italy.
  14. UO Reumatologia, AO Ordine Mauriziano, Torino, Italy.
  15. Reumatologia, Nuovo Ospedale di Prato, Italy.
  16. SC Reumatologia, PO Cairo Montenotte, Ospedale San Paolo, Savona, Italy.
  17. Rheumatology, Allergology and Clinical Immunology, University of Roma Tor Vergata, Rome, Italy.
  18. UOC di Reumatologia, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza Università di Roma, Italy.
  19. UO Reumatologia, AUSL 5 Jesi, Ospedale C.Urbani, Jesi, Università Politecnica delle Marche, Ancona, Italy.
  20. UO Reumatologia, IRCCS Policlinico San Matteo di Pavia, and Department of Clinical Sciences and Community Health, University of Milan, Italy.
  21. UO Reumatologia, Presidio Ospedaliero di Pescara, Italy.
  22. AbbVie Srl, Roma, Italy.
  23. AbbVie Srl, Roma, Italy.
  24. Department of Rheumatology, ASST Gaetano Pini-CTO, Milan, Italy.

2021 Vol.39, N°5
PI 0961, PF 0969
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PMID: 33427620 [PubMed]

Received: 19/04/2020
Accepted : 31/08/2020
In Press: 06/01/2021
Published: 31/08/2021


To evaluate the health-related quality of life (HRQoL), disease activity, treatment adherence, and work ability in the real-world setting in patients with axial spondyloarthritis (axSpA).
QUASAR was a prospective 12-month, observational study involving 23 rheumatology centres across Italy, including adult patients with axSpA according to the Assessment of SpondyloArthritis International Society (ASAS) criteria. Patients were followed at baseline, 3, 6, and 12 months for disease activity and health-related QoL (HRQoL), treatment adherence and work ability. Regression analysis was used to assess the association between treatment and outcome variables.
413 (80.7%) out of axSpA 512 patients were diagnosed with ankylosing spondylitis (AS) and 99 (19.3%) with non-radiographic axSpA (nr-axSpA). Nr-axSpA and AS patients had similar baseline disease activity and HRQoL. Biologic disease-modifying anti-rheumatic drugs (bDMARDs) were the most frequent medication (n=426, 83.2%). Over the 1-year follow-up, disease activity measures (joint pain and swelling, CRP, global assessment, BASDAI, ASDAS), HRQoL and work ability significantly improved, while few differences emerged between nr-axSpA and AS patients. Treatment satisfaction and adherence questionnaires improved over the 12 months. Patients treated with bDMARDs showed improved outcomes for disease activity measures and HRQoL variables, greater benefit observed in patients with AS.
We found clinical and HRQoL improvement over 1 year in a large, real-world population of nr-axSpA and AS patients treated with bDMARDs or conventional synthetic DMARDs.

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