title: Assessment of work instability in spondyloarthritis: a cross-sectional study using the ankylosing spondylitis work instability scale.
abstract: OBJECTIVE
  Work status is an important outcome in SpA. The objective was to assess work instability and its determinants in a cohort of patients with SpA, using the AS-work instability scale (AS-WIS).
  
  
  METHODS
  We performed a cross-sectional monocentre study. Patients were definite SpA patients with paid work. Work instability was measured by the AS-WIS. Its determinants were assessed by correlations with SpA scores (BASDAI, BASFI and patient's global assessment) and patients with low work instability (AS-WIS score < 11) were compared with those with moderate to high instability, through backward logistic regression.
  
  
  RESULTS
  In all, 156 patients were assessed: mean (s.d.) age 41 (11) years, mean disease duration 15 (11) years; 71 (45.5%) were on TNF blockers. The mean AS-WIS score was 9.5 (5.5); 55 (35%) patients had moderate and 8 (5%) patients had high work instability. Correlations of the AS-WIS score with SpA scores were significant but moderate (BASDAI R = 0.42, BASFI R = 0.41, patient's global assessment R = 0.53; P < 0.0001). In multivariate analysis, high patient's global assessment was the only element associated with moderate to high work instability; demographic characteristics and treatments were not significant elements.
  
  
  CONCLUSIONS
  Work instability was found to be high and its main determinant was patient's global assessment. The predictive validity of the AS-WIS in terms of job retention should be further assessed.
authors.affiliation: Medicine Faculty, Paris Descartes University, APHP, Rheumatology B Department, Cochin Hospital, Paris, France. isabelle.fabreguet@gmail.com
authors.forename: Isabelle
authors.initials: I
authors.lastname: Fabreguet
authors.forename: Eugénie
authors.initials: E
authors.lastname: Koumakis
authors.forename: Vincent
authors.initials: V
authors.lastname: Burki
authors.forename: Anne
authors.initials: A
authors.lastname: Durnez
authors.forename: Muriel
authors.initials: M
authors.lastname: Elhai
authors.forename: Magali
authors.initials: M
authors.lastname: Meyer
authors.forename: Simon
authors.initials: S
authors.lastname: Paternotte
authors.forename: Judith
authors.initials: J
authors.lastname: Payet
authors.forename: Fanny
authors.initials: F
authors.lastname: Roure
authors.forename: Bruno
authors.initials: B
authors.lastname: Fautrel
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D018434:Sickness Impact Profile; D013167:Spondylitis, Ankylosing / Q000175:diagnosis / Q000503:physiopathology*