Journal
ARTHRITIS CARE & RESEARCH
Volume 63, Issue 7, Pages 1055-1061Publisher
WILEY-BLACKWELL
DOI: 10.1002/acr.20471
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Funding
- Canadian Institutes of Health Research
- National Institute of Arthritis and Musculoskeletal and Skin Diseases [U54AR057319]
- National Center for Research Resources [U54RR019497]
- Office of Rare Diseases Research
- US FDA [R01-FD003516-01]
- Schering-Plough
- Menarini UK
- Roche UK
- Nordic Group
- GlaxoSmithKline
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Objective. Antineutrophil cytoplasmic antibody associated vasculitis (AAV) can present with a broad spectrum of signs and symptoms:The relative effects of different manifestations on health-related quality of life (HRQOL) are unknown. Methods. We conducted an individual patient data meta-analysis of baseline Short Form 36 (SF-36) scores from 4 randomized controlled trials of patients with newly diagnosed AAV. We determined the associations between organ manifestations at trial entry and the SF-36 physical composite score (PCS) and mental composite score (MCS) using mixed-effects models adjusted for demographic factors. Associations with each of the 8 domains of the SF-36 were further explored using multivariate multiple regression. Results. SF-36 data were available from 346 patients. Older age (-0.11 points/year [95% confidence interval (95% CI) -0.21, -0.012]: P = 0.029) and neurologic involvement (-5.84 points; P < 0.001) at baseline were associated with lower PCS. Physical functioning scores were the most affected and older age scores (-0.25 points/year [95% CI -0.38, -0.11]; P < 0.001) and neurologic involvement (-8.48 points [95% CI -12.90, -4.06]: P < 0.001) had the largest effects. The MCS was negatively affected only by chest involvement (P = 0.027), but this effect was not exerted in any particular domain. Conclusion. In patients with newly diagnosed AAV, HRQOL is complex and incompletely explained by their organ system manifestations.
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