Clinical characteristics, treatments, and their impact on quality of life and work productivity in chilean patients with spondyloarthritis: A web-based survey study

Abstract

Objective: To describe the clinical characteristics, treatments used, and the impact of spondyloarthritis (SpA) on the quality of life and work productivity of patients in Chile. Methods: A cross-sectional study based on a self-administered web survey targeting patients with a diagnosis of SpA. Validated instruments such as BASDAI, BASFI, ASAS-HI, WPAI, and FiRST were used. Results were compared between users and non-users of biological therapies or JAK inhibitors. Results: A total of 346 patients were included, with a median age of 43 years; 70.8% were women. The median diagnostic delay was 4 years. A. total of 41.9% reported being HLA-B27 positive. The most frequent diagnosis was radio- graphic axial SpA. (71.1%). Regarding treatments, 76.3% used NSAIDs, 44.8% synthetic DMARDs, 33.5% biological or JAK inhibitor therapies, and 30.9% opioids. High disease activity (BASDAI > 4) was found in 78% of patients, and 27.8% had an ASAS-HI > 12. The WPAI indicated a substantial work impact: median presenteeism and total work productivity loss were both 50%, and impairment in general activities reached 60%. Users of biologics or JAK inhibitors had lower disease activity (BASDAI 5.1 vs 6.2; p = 0.0004), better functional capacity (BASFI 4.4 vs 5.6; p = 0.0206), lower subjective disease impact, and reduced productivity loss (46.3% vs 50%; p = 0.0151) compared to non-users. Conclusion: The findings reveal a high disease burden among Chilean patients with SpA, associated with limited use of advanced therapies and barriers to treatment access. These results underscore the need for more effective and accessible diagnostic and therapeutic strategies, and greater awareness of the social and occupational impact of the disease.