Session Information
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Few studies have reported impaired health related quality of life (HRQoL) in patients with primary antiphospholipid syndrome (APS); however the causes of this outcome have been scarcely explored. Our aim was to evaluate HRQoL in patients with primary APS and to correlate it with a crude estimate of accrual organ damage, comorbidity and treatment.
Methods: We registered demographics, criteria and non-criteria APS features, comorbidities (diabetes mellitus, hypertension, dyslipidemia) and use of oral anticoagulation, immunosuppressors and prednisone. We assessed HRQoL with the SF-36 as a generic instrument and in the absence of a specific HRQoL questionnaire for APS, we used the Spanish version LupusQoL. We also evaluated the disease burden with a modified SLICC/ACR SDI including four additional items (livedo racemosa, adrenal infarcts requiring chronic treatment, permanent Greenfield filter replacement and multiple sclerosis-like disease). As controls we used SF-36 data from Mexican general population within the same age range.
Results: We included 50 patients (86% women), mean age 47.6 ± 14.5 years, median disease duration 9.4 years, median SLICC/ACR score of 1 point. Eighty percent had thrombotic events, 28% pregnancy morbidity and 72% non-criteria APS features (non-exclusive groups). APS patients had lower HRQoL than controls (SF-36= 66.1 ± 22.4 vs. 96.3 ± 29.8, p=0.0001). The results of each domain of SF-36 and LupusQoL are shown at Table 1. We found a positive correlation between SF-36 and LupusQoL (r=0.85, p<0.0001). The SLICC/ACR DI correlated negatively with both LupusQol and SF-36, specifically the peripheral vascular domain (r=-0.29, p=0.03, for both instruments). Patients on anticoagulant therapy (n=37) had lower LupusQoL physical functioning, intimate relationships, burden to the others and pain scores than patients without them. They also had a lower SF-36 physical functioning score. We did not find differences in HRQoL regarding comorbidities, prednisone and immunosuppressors use. Table 1.
|
SF-36 |
|
LupusQoL |
|
| Total score |
66 ± 22.4 |
|
69 ± 29.36 |
|
Comparable domains |
|||
| Physical functioning |
71.9 ± 27.5 |
Physical health |
77.6 ± 19.7 |
| Mental health |
64.6 ± 19.4 |
Emotional health |
78.1 ± 18.1 |
| Bodily pain |
68.8 ± 25.5 |
Pain |
81.3 ± 23.7 |
| Vitality |
54.8 ± 21.5 |
Fatigue |
74.1 ± 19.5 |
|
Non Comparable domains |
|||
| Role physical |
71.5 ± 40.7 |
Planning |
82.3 ± 23.8 |
| General health |
56.9 ± 22.5 |
Intimate relationships |
77.9 ± 35.5 |
| Social functioning |
78.8 ± 22 |
Burden to others |
67.1 ± 30.8 |
| Role emotional |
60.6 ± 44.6 |
Body image |
79.1 ± 24.2 |
| Physical component summary score |
64.6 ± 22.6 |
Not applicable |
Not applicable |
| Emotional component summary score |
67.6 ± 26 |
Not applicable |
Not applicable |
Conclusion: HRQoL in APS is related to burden of the disease specifically at the vascular peripheral area and use of anticoagulation treatment.
To cite this abstract in AMA style:
Hernandez-Molina G, Gonzalez-Pérez I, Pacheco C, Cabral AR. Quality of Life in Patients with Antiphospholipid Syndrome Is Related to Disease Burden and Anticoagulant Therapy [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/quality-of-life-in-patients-with-antiphospholipid-syndrome-is-related-to-disease-burden-and-anticoagulant-therapy/. Accessed .« Back to 2016 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/quality-of-life-in-patients-with-antiphospholipid-syndrome-is-related-to-disease-burden-and-anticoagulant-therapy/