Session Information
Date: Sunday, November 8, 2015
Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's - Clinical Aspects and Therapeutics Poster I
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose:
Health-related quality of life (HRQoL) research is a priority in systemic sclerosis (SSc). Yet, much of the data comes from prevalent cohorts with established disease. There is a paucity of HRQoLdata in early SSc. The objective of this study was to estimate the magnitude of impairment in HRQoL, measured using the Medical Outcomes Trust Short Form-36 (SF-36), and the clinical correlates of physical and mental HRQoLin an inception SSc cohort.
Methods:
Cross-sectional study of incident SScsubjects (defined as < 2 years since onset of first non-Raynaud’s disease symptom) enrolled in the International Systemic Sclerosis Inception Cohort (INSYNC) cohort. Subjects were assessed at entry with standardized clinical histories, medical examinations, and self-administered questionnaires and data were entered and harmonized in a central Redcap database. Multiple linear regression was used to assess the relationship between selected demographic and clinical variables and the SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, adjusting for age, gender and race/ethnicity. Norm based scoring, where the mean score for the general population is 50 with a standard deviation (SD) of 10, was used to score SF-36 domain and summary scores. Values below 50 therefore indicate worse and above 50 better HRQoL, and each point is one tenth of a SD, compared to the general population.
Results:
The study included 483 incident SSc subjects (81% woman, mean (+SD) age 54.1+13.1 years, 89% White). Almost half (48.7%) of the cohort had diffuse cutaneous SSc (dcSSc), 27% interstitial lung disease (ILD), 6.0% pulmonary arterial hypertension (PAH) and 5.1% scleroderma renal crisis (SRC).
There were considerable impairments in all 8 SF-36 domains, with the worst scores for physical functioning (mean 36.5±12.7), role physical (36.4±13.9) and general health (38.6+10.8). Impairment was almost 1.5 SD below that of the general population in the SF-36 PCS (37.2± 12.0) and almost half of a SD below in the SF-36 MCS (45.7+12.7).
In multiple linear regression analysis, dcSSc (β -7.3, 95% confidence interval (CI) -10.0; -4.5, p<0.001), PAH (β -10.8, 95% CI -17.0; -4.6, p=0.001) and SRC (β -5.8, 95% CI -11.5; -0.15, p=0.04), but not ILD, were significant independent correlates of the SF-36 PCS score. The model explained 15% of the variance in the SF-36 PCS. On the contrary, ILD (β-4.1, 95% CI -7.6; -0.7, p=0.019), but not dcSSc, PAH or SRC, was a significant independent correlate of the SF-36 MCS. This model explained 4.7% of the variance in the SF-36 MCS.
Conclusion:
This study provides robust evidence of the magnitude and correlates of impairment in HRQOL in early SSc. Effective therapies are urgently needed to improve HRQoL in SSc.
To cite this abstract in AMA style:
Hudson M, Baron M, Wang M, Rabusa C, Proudman S, Nikpour M, Stevens W. Health-Related Quality of Life in Early Systemic Sclerosis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/health-related-quality-of-life-in-early-systemic-sclerosis/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/health-related-quality-of-life-in-early-systemic-sclerosis/