{
  "abstract": "Objectives To compare the spondyloarthritis (SpA) specific universal health utility estimation from the ASAS health index (U-ASAS-HI) with the generic EuroQol-5D-3L (EQ-5D-3L) utility among SpA subtypes and to understand the contribution of health-, personal- and country-level factors to the U-ASAS-HI.Methods Ancillary analysis of the ASAS-PERipheral involvement in SpondyloArthritis (PerSpA) study including patients who completed both ASAS-HI and EQ-5D-3L. Correlations between U-ASAS-HI and EQ-5D-3L were tested overall and by subtype (axial SpA, peripheral SpA and psoriatic arthritis (PsA)). Health and contextual determinants of U-ASAS-HI were evaluated using multivariable linear mixed-effects models with country as level.Results 4158 patients were included, mean age 44 (SD:13) and 61% male. Mean U-ASAS-HI was 0.44 (SD:0.30) and mean EQ-5D-3L was 0.71 (SD:0.21), with numerically minor differences between subtypes. Correlations between U-ASAS-HI and EQ-5D-3L were consistently strong between subgroups (range 0.74–0.76). Linear mixed-effects modelling showed health outcomes, including disease activity (axial spondyloarthritis disease activity score; β=−0.030, 95% CI −0.038 to −0.021), physical function (bath ankylosing spondylitis functional index; β=−0.044, 95% CI −0.048 to −0.041), anxiety/depression (EQ-5D-3L q5; β=−0.147, 95% CI −0.160 to −0.134) and fibromyalgia (fibromyalgia rapid screening tool; β=−0.068, 95% CI −0.083 to −0.053) were strong predictors of lower U-ASAS-HI. Additionally, female gender, PsA subtype, axial involvement, fatigue and having no employment were associated with lower U-ASAS-HI while older age and university education were associated with higher U-ASAS-HI. The random-effects model indicated an intraclass correlation coefficient of 6% in total variance attributable to differences between countries.Conclusion The universal U-ASAS-HI captures the broad range of aspects relevant to valuing SpA health states across SpA subtypes. The lower absolute values of U-ASAS-HI reflect the wider disutility associated with SpA.",
  "authors": [
    {
      "affiliations": [
        "Department of Rheumatology, Rheumazentrum Ruhrgebiet, Herne, Germany",
        "Medical School, Ruhr University Bochum, Bochum, Germany",
        "Cellular and Molecular Immunology Group (InmuBo), Universidad El Bosque, Bogotá, Colombia"
      ],
      "name": "Omar-Javier Calixto"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Rheumazentrum Ruhrgebiet, Herne, Germany",
        "Medical School, Ruhr University Bochum, Bochum, Germany"
      ],
      "name": "Xenofon Baraliakos"
    },
    {
      "affiliations": [
        "Cellular and Molecular Immunology Group (InmuBo), Universidad El Bosque, Bogotá, Colombia",
        "Department of Rheumatology, Hospital Universitario de la Fundacion Santa Fe de Bogota, Bogota, Colombia"
      ],
      "name": "Wilson Bautista-Molano"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Maastricht University Medical Centre+, Maastricht, The Netherlands",
        "Care & Public Health Research Institute (Caphri), Maastricht University, Maastricht, The Netherlands"
      ],
      "name": "Annelies Boonen"
    },
    {
      "affiliations": [
        "Care & Public Health Research Institute (Caphri), Maastricht University, Maastricht, The Netherlands"
      ],
      "name": "Sander van Kuijk"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Maastricht University Medical Centre+, Maastricht, The Netherlands"
      ],
      "name": "Ivette Essers"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain",
        "GC05, IMIBIC, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain"
      ],
      "name": "Clementina López-Medina"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Hôpital Cochin, Assistance Publique, Hôpitaux de Paris, Université de Paris, Paris, France",
        "INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France"
      ],
      "name": "Maxime Dougados"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Rheumazentrum Ruhrgebiet, Herne, Germany",
        "Medical School, Ruhr University Bochum, Bochum, Germany"
      ],
      "name": "Uta Kiltz"
    }
  ],
  "title": "Evaluation of spondyloarthritis-specific health utility based on ASAS health index (U-ASAS-HI) among the disease subtypes: an ancillary analysis from the ASAS-PerSpA study",
  "uid": "4a49b286-1627-5683-9c32-e5a151e19137"
}