AB0633 Health-Related Quality of Life in ANCA Vasculitides and Rheumatoid Arthritis patients: a cross-sectional comparative study

Abstract

BackgroundANCA associated vasculitides (AAVs) are rare, serious forms of vasculitides. There are limited data regarding the quality of life in patients with AAVs compared to other chronic inflammatory diseases.ObjectivesThe purpose of this study was to compare the quality of life between patients with AAV and those with a chronic inflammatory arthritis such as rheumatoid arthritis (RA).MethodsMulticenter, cross-sectional study of AAV and RA patients followed in three tertiary referral centers. Data from 1007 healthy controls served as historic controls.1 HRQoL was assessed with the Short Form 36 Health Survey (SF-36) which includes physical and mental component summary scores (PCS and MCS). Disease activity were assessed with the Birmingham Vasculitis Activity Score version 3 (BVAS 3, for AAVs) and the DAS28-ESR (for RA) respectively and organ damage/function with the Vasculitis Damage Index (VDI for AAVs) score and Health Assessment Questionnaire (HAQ for RA) scores, respectively.Results66 patients with AAVs (GPA 62%, MPA 29% and EGPA 9%, females 56%, mean age 63.4 years, generalized disease 74%, mean disease duration 6.2 years, remission 73%) and 71 with RA (females 56%, mean age 63.3 years, remission 72%) were included. Both AAV and RA patients had significantly lower PCS and MCS scores compared to healthy controls (p < 0.05) while RA patients had lower PCS and MCS scores compared to AAV patients (p < 0.05). According to disease activity status, there was no difference in the SF-36 scores between those with active (BVAS > 1) and inactive (BVAS < 1) AAV, except for the energy-fatigue component (55.0 ± 21.8 vs. 67.2 ± 20.7, p= 0.038) whereas patients with active RA (DAS28-ESR > 3.2) had lower scores for all SF36 components compared to those with low disease activity (DAS28-ESR < 3.2). Additionally, active RA patients had lower both PCS and MCS scores compared to active AAV patients (p < 0.05). AAV patients with increased damage scores (VDI > 3) had lower PCS score compared to those with less organ damage (VDI < 3), (33.9 ± 10.1 vs. 49.1 ± 10.2, p < 0.001) while RA patients with increased damage/poor functionality (HAQ ≥ 0.75) had lower both PCS and MCS scores compared to those with less damage (HAQ ≤ 0.63), (35.0 ± 7.2 vs. 48.4 ± 8.6, p < 0.001) and (40.5 ± 8.6 vs. 48.2 ± 7.6, p < 0.001 respectively). Compared to patients with AAV, RA patients with increased damage had lower score for the pain component compared to AAV patients (37.7 ± 28.6 vs. 61.2 ± 29.5, p= 0.024).ConclusionIn general, patients with AAV and RA, demonstrate impaired quality of life compared to healthy controls. In the AAV group, quality of life correlated more with organ damage and less with disease activity whereas in RA patients, quality of life correlated both with disease activity and damage. These data emphasize the need for more efficacious therapies for AAV patients that could prevent chronic organ damage and improve quality of life.References[1]Pappa, E., Kontodimopoulos, N. & Niakas, D. Validating and norming of the Greek SF-36 Health Survey. Qual Life Res 14, 1433–1438 (2005).AcknowledgementsSupported in part by the Greek Rheumatology Society and Professional Association of Rheumatologists (ERE-EPERE) and the Special Account for Research Grants (S.A.R.G.), National and Kapodistrian University of Athens, Athens, Greece (DV #12085, 12086).Disclosure of InterestsNone declared

Recent advances in the treatment strategy for AAV improved outcomes with intensive GC tapering

“…We found that most of the deaths had high VDI at 24 months (Table S1). Previous studies showed that the progression of VDI associated not only with survival of AAV patients but also with decrease in quality of life 4,26,27 . Our AAV patients were evaluated by the ECOG‐PS (performance status), a assessment tool for the physical activity of cancer patients on a 5‐point scale 23 .…”