Evidence map›Paper›PMID 41017719›Full record

ArticleRheumatology (Oxford, England)2026

Disease activity and mental health symptoms in axial spondyloarthritis: concordant or discordant?

Sizheng Steven Zhao, Casper Webers, Elena Nikiphorou, Désirée van der Heijde, Jürgen Braun, Uta Kiltz, Sofia Ramiro, Annelies Boonen

Abstract read
In one paragraph

Article in Rheumatology (Oxford, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sizheng Steven ZhaoCentre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Science, University of Manchester, Manchester, UK.ORCID 0000-0002-3558-7353
Casper WebersCare and Public Health Research Institute (Caphri), Maastricht University, Maastricht, the Netherlands.ORCID 0000-0003-3011-8547
Elena NikiphorouSchool of Inflammation and Microbial Sciences, Centre for Rheumatic Diseases, King's College London, London, UK.ORCID 0000-0001-6847-3726
Désirée van der HeijdeLeiden University Medical Centre, Leiden, the Netherlands.ORCID 0000-0002-5781-158X
Jürgen BraunRheumatologisches Versorgungszentrum RVZ Steglitz, Ruhr Universität Bochum, Berlin, Germany.
Uta KiltzRheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany.ORCID 0000-0001-5668-4497
Sofia RamiroLeiden and Zuyderland Medical Center, Leiden University Medical Center, Heerlen, the Netherlands.ORCID 0000-0002-8899-9087
Annelies BoonenCare and Public Health Research Institute (Caphri), Maastricht University, Maastricht, the Netherlands.ORCID 0000-0003-0682-9533

Funding

ASAS Health Index Validation StudyNIHR Manchester Biomedical Research Centre NIHR203308The University of Manchester Dean's PrizeVersus Arthritis 21173Versus Arthritis 21754Versus Arthritis 21755Versus Arthritis Career Development Fellowship 23258
6 · The paper itself

Abstract

objectiveWe applied latent class and trajectory modelling to examine whether subgroups of axial spondylarthritis (axSpA) patients report discordant scores for disease activity and mental health symptoms at baseline and after treatment change.

methodsWe analysed axSpA patients from the ASAS Health Index International Validation Study. We applied latent class analysis (LCA) using generalized structural equation modelling to identify subgroups among 1292 individuals, based on baseline Hospital Anxiety and Depression Scale (HADS) subscores and ASDAS. We applied trajectory modelling in a subset (n = 206) requiring treatment change, to identify subgroups of distinct trajectories for HADS and ASDAS over 6 months. All indices were standardized. Baseline characteristics were compared across identified groups.

resultsFor the baseline analysis, three groups were identified with concordant HADS subscores and ASDAS, with similar baseline characteristics except the high HADS/ASDAS group having more peripheral joint involvement and higher CRP levels. Trajectory analysis identified four groups with concordant HADS and ASDAS changes: 54% comparatively low baseline values, 33% medium and, of the high baseline groups, some (7%) had marked improvement (HADS-depression Δ11, HADS-anxiety Δ9, ASDAS Δ2.8), while others (6%) had limited ASDAS improvement (Δ1.4) with minimal changes in anxiety symptoms (Δ0.6).

conclusionsWe did not identify the hypothesized subgroups with discordant disease activity and mental health symptoms. Instead, these domains were closely aligned at baseline and following treatment, suggesting that these symptoms influence each other. Patients with high mental health symptom burden may benefit from knowing that these symptoms often improve alongside disease activity when starting treatment.

Indexed as

AnxietyAxial SpondyloarthritisDepressionMental HealthSpondylarthritisAdultFemaleHumansLatent Class AnalysisMaleMiddle AgedSeverity of Illness Indexanxietyaxial spondyloarthritisdepressiongroup-based trajectory analysislatent class analysismental health

Identifiers

PMID41017719
PMCPMC12862361

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.