ORIGINAL PAPER
Health-related quality of life impairment is equal for antiphospholipid syndrome whether primary or associated with systemic lupus erythematosus
More details
Hide details
1
Eli Lilly and Company, Indianapolis, USA
2
Connective Tissue Diseases Clinic, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
Submission date: 2024-06-06
Final revision date: 2024-07-09
Acceptance date: 2024-08-05
Publication date: 2024-09-16
Corresponding author
Ewa Haladyj
Eli Lilly and Company, Indianapolis, IN 46285, USA
Reumatologia 2024;62(4):266-273
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Antiphospholipid syndrome (APS) manifests with thrombosis and pregnancy losses and may significantly impair the health-related quality of life (HRQoL). So far, APS has been perceived as a less burdensome disease than systemic lupus erythematosus (SLE), but data on this are scarce. The purpose of the present study was to evaluate HRQoL in APS patients by applying the Short Form 36 Health Survey (SF-36) and World Health Organization Quality-of-Life Scale (WHOQoL-BREF); to examine the impact of primary APS and with coexisting SLE (APS/SLE) on patient HRQoL; and to provide a description of the APS patient population.
Material and methods:
One hundred twelve patients with APS were included in the study, 57 of them with primary APS and 55 with coexisting SLE. HRQoL was measured by the 36-Item SF-36 and WHOQoL questionnaires.
Results:
Mean age was 47 years (47.6 ±13.8), and 96 patients were (85.7%) women. The mean disease duration was 72 months. Health-related quality of life impairment was found in both components for all APS patients in comparison to the healthy Polish population (p < 0.0001). There was no difference between APS and APS/SLE groups in HRQoL (mental component p = 1.0, physical component p = 0.337). The history of venous thrombosis was associated with HRQoL impairment only in the APS/SLE group in the physical component (p = 0.0118), not in primary APS (p = 0.6862). The mental component of SF-36 was associated with all domains of WHOQoL-BREF, while the physical component was associated only with physical health (p < 0.001).
Conclusions:
Primary APS and APS secondary to SLE lead to equal impairment in HRQoL. Diagnosis and proper management of all patients with APS are essential to prevent thrombosis and miscarriages, which ultimately will lead to longer survival with optimal life quality.
REFERENCES (34)
1.
Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4: 295–306.
2.
Hughes GRV. Migraine, memory loss, and multiple sclerosis. Neurological features of the antiphospholipid (Hughes’) syndrome. Postgrad Med J 2003; 79: 81–83, DOI: 10.1136/pmj.79.928.81.
3.
Kahn SR, Hirsch A, Shrier I. Effect of post-thrombotic syndrome on health-related quality of life after deep venous thrombosis. Arch Intern Med 2002; 162: 1144–1148, DOI: 10.1001/ archinte.162.10.1144..
4.
Kahn SR, Shbaklo H, Lamping DL, et al. Determinants of health related quality of life during the 2 years following deep vein thrombosis. J Thromb Haemost 2008; 6: 1105–1112, DOI: 10.1111/ j.1538-7836.2008.03002.x.
5.
Kahn SR, Elman EA, Bornais C, et al. Post-thrombotic syndrome, functional disability and quality of life after upper extremity deep venous thrombosis in adults. J Thromb Haemost 2005; 93: 499–502, DOI: 10.1160/TH04-10-0640.
6.
Özel F, Argon G. The effects of fatigue and pain on daily life activities in systemic lupus erythematosus. Agri 2015; 27: 181–189, DOI: 10.5505/agri.2015.38278.
7.
Madureira S, Canhão P, Ferro JM. Cognitive and behavioural outcome of patients with cerebral venous thrombosis. Cerebrovasc Dis 2001; 11: 108.
8.
Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med 1993; 118: 622–629, DOI: 10.7326/ 0003-4819-118-8-199304150-00009.
9.
McElhone K, Abbott J, Teh LS. A review of health related quality of life in systemic lupus erythematosus. Lupus 2006; 15: 633–643, DOI: 10.1177/0961203306071710.
10.
Seawell AH, Danoff-Burg S. Psychosocial research on systemic lupus erythematosus: a literature review. Lupus 2004; 13: 891–899, DOI: 10.1191/0961203304lu1083rr.
11.
Hughes GRV. Hughes syndrome: A patient’s guide. Springer- Verlag, London 2001.
12.
Cervera R, Piette JC, Font J, et al. Antiphospholipid syndrome: Clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients. Arthritis Rheum 2002; 46: 1019–1027, DOI: 10.1002/art.10187.
13.
Strand V, Singh JA. Improved Health related Quality of Life with effective disease-modifying antirheumatic drugs: evidence from randomized controlled trials. Am J Manag Care 2007 Suppl 9: S237–S251.
14.
Boers M, Brooks P, Strand V, et al. The OMERACT filter for outcomes measures in rheumatology. J Rheumatol 1998; 25: 198–199.
15.
Picavet HSJ, Hoeymans. Health related quality of life in multiple musculoskeletal diseases: SF36 and EQ-ED in the DMC3 study. Ann Rheum Dis 2004; 63: 723–729, DOI: 10.1136/ard. 2003.010769.
16.
Ware JE. SF-36 health survey update. Lincoln: Quality- Metric Incorporated; Spine 2000; 25: 3130–3139, DOI: 10.1097/ 00007632-200012150-00008.
17.
Ciconelli RF, Santos MR, Meiraos I. Translation into Portuguese and validation of the generic questionnaire for assessing quality of life SF-36 Brazil SF-36. Rev Bras Reumatol 1999; 39: 143–150.
18.
McHorney CA, Ware JE Jr, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993; 31: 247–263, DOI: 10.1097/00005650-199303000-00006.
19.
Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Qual Life Res 1993; 2: 153–159, DOI: 10.1007/BF00435734.
20.
Wang SL, Wu B, Zhu LA, et al. Construct and criterion validity of the euro Qol-5D in patients with systemic lupus erythematosus. PLoS One 2014; 9: e98883, DOI: 10.1371/journal.pone.0098883.
21.
Wang C, Mayo N, Fortin P. The relationship between related quality of life and disease activity and damage in systemic lupus erythematosus. J Rheumatol 2001; 28; 3: 525–532.
22.
García-Carrasco M, Mendoza-Pinto C, Cardiel MH, et al. Health related quality of life in Mexican women with systemic lupus erythematosus: a descriptive study using SF36 and LupusQol. Lupus 2012; 21: 1219–1224, DOI: 10.1177/0961203312456749.
23.
Thumboo J, Strand V. Health-related quality of life in patients with systemic lupus erythematosus an update. Ann Acad Med Singap 2007; 36: 115–122.
24.
Bazzan M, Vaccarino A, Marletto F. Systemic lupus erythematosus and thrombosis. Thromb J 2015; 13: 16.
25.
Zuily S, Rat AC, Regnault V, et al.; TAC(I)T investigators. Impairment of quality of life in patients with antiphospholipid syndrome. Lupus 2015; 24: 1161–1168, DOI: 10.1177/ 0961203315580871.
26.
Georgopoulou S, Efraimidou S, MacLennan SJ, et al. Antiphospholipid (Hughes) syndrome: description of population and health-related quality of life (HRQoL) using the SF-36. Lupus 2015; 24: 174–179, DOI: 10.1177/0961203314551809.
27.
Hernández-Molina G, González-Pérez I, Pacheco-Molina C, Cabral AR. Quality of life in patients with the antiphospholipid syndrome is related to disease burden and anticoagulant therapy. Int J Rheum Dis 2017; 20: 755–759, DOI: 10.1111/1756-185X.13045.
28.
Balitsky AK, Peeva V, Su J, et al. Thrombovascular events affect the quality of life in patients with systemic lupus erythematosus. J Rheumatol 2011; 38: 1017–1019, DOI: 10.3899/jrheum.101054.
29.
Hopman WM, Towheed T, Anastassiades T, et al. Canadian normative data for the SF-36 health survey. Canadian Multicentre Osteoporosis Study Research Group. CMAJ 2000; 163: 265–271.
30.
Brown N, Melville M, Gray D, et al. Comparison of the SF-36 health survey questionnaire with the Nottingham Health Profile in long-term survivors of a myocardial infarction. J Public Health Med 2000; 22: 167–175, DOI: 10.1093/pubmed/22.2.167.
31.
van Korlaar IM, Vossen CY, Rosendaal FR, et al. The impact of venous thrombosis on quality of life. Thromb Res 2004; 114: 11–18, DOI: 10.1016/j.thromres.2004.04.007.
32.
Huang I-C, Wu AW, Frangakis C. Do the SF-36 and WHOQOL-BREF measure the same constructs? Evidence from the Taiwan population. Qual Life Res 2006; 15: 15–24, DOI: 10.1007/ s11136-005-8486-9.
33.
Hsiung PC, Fang CT, Chang YY, et al. Comparison of WHOQOL-BREF and SF-36 in patients with HIV infection. Qual Life Res 2005; 14: 141–150, DOI: 10.1007/s11136-004-6252-z.
34.
Abbasi-Ghahramanloo A, Soltani-Kermanshahi M, Mansori K, et al. Comparison of SF-36 and WHOQoL-BREF in Measuring Quality of Life in Patients with Type 2 Diabetes. Int J Gen Med 2020; 13: 497–506, DOI: 10.2147/IJGM.S258953.
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (
https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.