Patient and physician perspectives on the impact of health-related quality of life in Mexican patients with ANCA-associated vasculitis.

ABSTRACT

The objective of this study is to describe aspects of health-related quality of life (HRQOL) in Mexican patients with antineutrophil cytoplasmic-associated vasculitis (AAV). Cross-sectional comparison study includes patients with established AAV and a comparison group with rheumatoid arthritis (RA), chronic kidney disease (CKD), and healthy subjects. Variables considered were socio-demographic data, comorbidities, laboratory, disease activity, damage, and Physician's and Patient's Global Assessment (PhGA and PtGA). The following measurements were done Pittsburg sleep quality index, Multidimesional Fatigue Inventory (MFI-20), Hospital Anxiety and Depression Scale, Short Form 36 questionnaire (SF-36), and Health Assessment Questionnaire. 60 patients with AAV were included, median age 54 years, and 60% female. Significant differences were found only in the bodily pain domain of the SF-36 (p = 0.01). Aspects of disease relevant for AAV patients were fatigue and lack of energy; visual abnormalities; neuropathy; renal impairment; arthritis, and sinusitis. Greater total score on MFI-20 (p < 0.001) and worse PtGA (p = 0.01) were associated with worse physical health. Higher PhGA values were associated with worse physical quality of life (p = 0.01). Greater fatigue score (p = 0.002), greater anxiety-depression score (p = 0.005), and worse PtGA (p = 0.01) were associated with worse mental health quality of life. No differences were found in prevalence of sleep impairment, anxiety, depression, or disability between groups. AAV patients experienced more general and physical fatigue (p < 0.0001), and reduced activity (p = 0.01) than healthy subjects, but similar to RA and CKD patients. Vasculitis has negative effects on patients' physical and mental HRQOL.