Session Type: Abstract Submissions (ACR)
Improved therapeutic strategies for ANCA-associated vasculitis (AAV) have transformed acute and life-threatening diseases into chronic ones responsible for marked morbidity that could impact employment, work disability and quality of life (QoL). The French EXPOVAS inquiry aimed to analyze work, handicaps and QoL of AAV patients and identify their determinants.
Patients with AAV seen in our department were included in a cross-sectional study assessing employment, work disability and QoL. Specific and non-specific questionnaires, including SF-36, were sent to 531 AAV patients. QoL was compared to that of the general population, patients with end-stage renal disease (ESRD), and previously reported AAV patients from the EUVAS cohort. Clinical-biological data that could affect QoL were recorded, and their determinants analyzed.
Questionnaires were completed by 198 patients (109 women (55%), mean age 59±14 years). Diagnoses were granulomatosis with polyangiitis for 132 (67%), eosinophilic granulomatosis with polyangiitis (EGPA) for 42 (21%) and microscopic polyangiitis for 24 (12%). Among 94 working-age (<60 years) patients, 57% had jobs, consistent with their qualifications for 81%; 77% were stably employed, with 67% working full-time. Concerning the impact of AAV, 23% of workers felt that their disease qualitatively limited the nature of their work, while 43% felt it limited the quantity of work they could do; 77% of patients did not benefit from any workstation adaptation; 50% thought their disease had hindered their careers and 43% that it had led to a salary reduction. 33% were not employed and not looking for work; and 9% were looking for a job. These results were comparable for the different vasculitides. QoL was significantly impaired for AAV patients compared to the general population (P<0.0001). In contrast, QoL of AAV patients was significantly better than that of ESRD patients. Finally, our AAV population’s QoL was similar to that of the EUVAS cohort, except for our patients’ physical functioning, which was better (P<0.001), and their mental health, which was more impaired (P<0.001). Physical health determinants for our population were an EGPA diagnosis, long disease duration and its neurological involvement, whereas mental health determinants were ear, nose & throat signs and cardiovascular involvement.
Our findings showed that AAV patients’ QoL was impaired compared to the general population, mainly for patients with EGPA and long-standing disease. In contrast, normal employment seemed to be preserved.
C. Le Jeunne,
L. Guillevin for the French Vasculitis Study Group,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/analysis-of-employment-work-disability-and-quality-of-life-of-patients-with-anca-associated-vasculitis/