Health-related quality of life in patients with newly diagnosed antineutrophil cytoplasmic antibody-associated vasculitis

Abstract

Background Anti-neutrophil cytoplasm antibody-associated vasculitis (AAV) can present with a broad spectrum of signs and symptoms. The relative effects of different manifestations on health related quality of life (HRQOL) is unknown. Methods We conducted an individual patient data meta-analysis of baseline Short Form 36 (SF-36) scores from four randomized controlled trials of patients with newly diagnosed AAV. We determined the associations between organ manifestations at trial entry and the SF-36 Physical Composite Score (PCS) and Mental Composite Score (MCS) using mixed effects models adjusted for demographic factors. Associations with each of the 8 domains of the SF-36 were further explored using multivariate multiple regression. Results SF-36 data was available from 346 patients. Older age (−0.11 points/year; 95% Confidence Interval [CI] −0.21 to −0.012; p=0.029) and neurologic involvement (−5.84, p<0.001) at baseline were associated with lower Physical Composite Scores. Physical Function scores were the most affected and older age (−0.25 points per year, 95% Confidence Interval [CI] −0.38 to −0.11; p<0.001) scores and neurologic involvement (−8.48 points, 95% CI −12.90 to −4.06; p<0.001) had the largest effects. The MCS was negatively affected only by chest involvement (p=0.027) but this effect was not exerted in any particular domain. Conclusions HRQOL in patients with newly diagnosed AAV are complex and incompletely explained by their organ system manifestations.

EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis

“…Personal and social relationships may be seriously disrupted, sometimes resulting in the total breakdown of family bonds. These factors may contribute to depression as a secondary consequence of AAV 150 151…”

The characterisation and determinants of quality of life in ANCA associated vasculitis

“…Walsh and colleagues were the first to examine the independent associations of QOL in AAV 19. Although their analysis was restricted to newly diagnosed patients and assessed only clinical factors, they also identified old age and neurological involvement as potentially important determinants of poor physical related QOL.…”

Trial of SLE therapies in real-world settings

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