{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T14:19:35Z","timestamp":1789395575097,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T00:00:00Z","timestamp":1729900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We determined whether socioeconomic status (SES) and sex are associated with functional status (FS) in axial spondyloarthritis (axSpA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cohort study of patients with axSpA in the Rheumatology Informatics System for Effectiveness registry. We performed cross\u2010sectional and longitudinal analyses of FS through the Multidimensional Health Assessment Questionnaire (MDHAQ) using generalized estimating equation models. Area Deprivation Index (ADI) was used as an SES proxy. The cross\u2010sectional analysis tested for a linear trend across ADI quintiles for MDHAQ. The longitudinal analysis\u2019 outcome was functional decline. We reported predictive margins and assessed for interaction with sex. In the longitudinal analysis, we reported odds of functional decline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the cross\u2010sectional analysis (N = 5,658), the mean \u00b1 SD age was 53.8 \u00b1 15.2 years, 55.8% were female, and 71.4% were non\u2010Hispanic White. The mean \u00b1 SD MDHAQ scores were 1.6 \u00b1 2.0 in men versus 2.1 \u00b1 2.2 in women. Predicted mean MDHAQ scores were 2.2 (95% confidence interval [CI] 1.8\u20132.7) for the lowest ADI quintile and 1.8 (95% CI 1.4\u20132.1) for the highest. Women had lower FSs compared to men across quintiles. In the longitudinal analysis (n = 2,341), the proportion with FS decline was 14.3% (95% CI 7.6\u201325.5%) for the lowest SES quintile compared to 9.6% (95% CI 5.2\u201317.1%) for the highest. Women had 1.7 (95% CI 1.3\u20132.2) times higher odds of functional decline compared to men. There was no interaction with sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this large sample of patients with axSpA, those with lower SES had worse FS and functional decline. Women had worse FS than men, initially and over time.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.25436","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T02:38:45Z","timestamp":1726713525000},"page":"376-384","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Low Socioeconomic Status and Female Sex are Associated With Worse Functional Status in Axial Spondyloarthritis"],"prefix":"10.1002","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0355-4020","authenticated-orcid":false,"given":"Rachael","family":"Stovall","sequence":"first","affiliation":[{"name":"University of Washington  Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3298-2112","authenticated-orcid":false,"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8435-8994","authenticated-orcid":false,"given":"Eric","family":"Roberts","sequence":"additional","affiliation":[{"name":"University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3456-0597","authenticated-orcid":false,"given":"Andriko","family":"Palmowski","sequence":"additional","affiliation":[{"name":"University of California San Francisco, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Berlin, Germany, and University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Anastasiou","sequence":"additional","affiliation":[{"name":"University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1867-0905","authenticated-orcid":false,"given":"Zara","family":"Izadi","sequence":"additional","affiliation":[{"name":"University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janna","family":"Friedly","sequence":"additional","affiliation":[{"name":"University of Washington  Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namrata","family":"Singh","sequence":"additional","affiliation":[{"name":"University of Washington  Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6314-5336","authenticated-orcid":false,"given":"Lianne S.","family":"Gensler","sequence":"additional","affiliation":[{"name":"University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2687-5043","authenticated-orcid":false,"given":"Gabriela","family":"Schmajuk","sequence":"additional","affiliation":[{"name":"University of California San Francisco, San Francisco VA Healthcare System, San Francisco, California, and University of California San Francisco Institute for Health Policy Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3508-4094","authenticated-orcid":false,"given":"Jinoos","family":"Yazdany","sequence":"additional","affiliation":[{"name":"University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-010-1665-2"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.19400"},{"issue":"9","key":"e_1_2_6_4_1","first-page":"1720","article-title":"Socioeconomic status and health in women with systemic lupus erythematosus","volume":"25","author":"Lotstein DS","year":"1998","journal-title":"J Rheumatol"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2021.04.210010"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-022-00833-0"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa543"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-011-1890-3"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-010-1581-5"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22001"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-019-2012-x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.060293"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-013-2439-4"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000005652"},{"key":"e_1_2_6_15_1","volume-title":"Modern Parenthood: Roles of Moms and Dads Converge as They Balance Work and Family","author":"Parker K","year":"2013"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003122410396194"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr2.11050"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23089"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009742.2015.1010572"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22682"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3952"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25219"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.201362"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20620"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31561-0"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.7326\/M13-2946"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.3414\/ME17-01-0051"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.014"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab638"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-214259"},{"key":"e_1_2_6_31_1","first-page":"jrheum.17666","article-title":"The sex influence on response to tumor necrosis factor\u2010\u03b1 inhibitors and remission in axial spondyloarthritis","author":"Lubrano E","year":"2017","journal-title":"J Rheumatol"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.90a.22019"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.15430"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-014-2955-9"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22748"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-017-3767-6"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.2196\/31186"},{"issue":"9","key":"e_1_2_6_38_1","article-title":"Development of the American College of Rheumatology toolkit for implementation of rheumatoid arthritis outcome measures in clinical practice [abstract]","volume":"75","author":"Nasrallah CJL","year":"2023","journal-title":"Arthritis Rheumatol"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1177\/1759720X20970028"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.25436","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T16:05:35Z","timestamp":1759421135000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.25436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,26]]},"references-count":38,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1002\/acr.25436"],"URL":"https:\/\/doi.org\/10.1002\/acr.25436","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,26]]},"assertion":[{"value":"2024-03-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}