Background/Purpose : Quality of life (QoL) is an important outcome in clinical care especially in patients with chronic disease such as systemic lupus erythematosus (SLE). In antiphospholipid syndrome (APS) which can be associated to SLE, QoL has not been clearly evaluated. Therefore our objective was to assess QoL in patients with antiphospholipid antibodies (aPL) and/or SLE in particular according to their APS status (thromboembolic history or obstetrical morbidity).

Methods: QoL was assessed in a multicentre cohort study using The Medical Outcomes Study Short-Form 36 (MOS-SF-36) in patients with aPL and/or SLE without anticoagulant treatment at inclusion. A score from 0 to 100 was calculated for each dimension and each component was normal at 50. QoL scores were compared between groups of patients and to the general population.

Results : One hundred and fifteen patients were included (mean age 42±14 years-old, 85 women). Seventeen patients had SLE and aPL, 16 only SLE and 82 only aPL. Fifty-eight patients were asymptomatic (i.e. without thrombotic or obstetrical history), while 57 patients had a history of one or several thrombotic manifestations and in 54 patients APS was diagnosed. The presence of APS was associated to a significant impairment of QoL on both mental component summary (MCS) (40.4±11.9 vs 45.7±10.4, p=0.01) and physical component summary (PCS) (46.6±9.6 vs 49.3±8.4, p=0.03) scores compared to those without APS (Fig. 1). Furthermore, in patients with history of arterial thrombosis compared to those without, Qol was dramatically impaired on all dimensions and both MCS (35.9±12.8 vs 44.6±10.6, p=0.008) and PCS (40.3±10.2 vs 49.5±8.1, p<0.001) scores (Fig. 2). Comparisons of QoL scores between patients with SLE and/or aPL and general population according to age and sex, showed a significant impairment of the majority of dimensions of QoL especially in men between 35 to 54 years-old, and in women between 25 to 54 years-old.

Conclusion: In patients with aPL and/or SLE, the presence of APS is associated with a significant impairment of QoL assessed by MOS-SF-36. History of arterial thrombosis was associated to the greatest impairment of QoL. Compared to the general population, we showed that these young patients experienced a decreased QoL which should be taken into account on everyday APS patient management.

                                               Figure 1                                                                                                Figure 2