Poor Physical Function at Baseline Associated With Premature Death in in patients with microscopic polyangiitis and granulomatosis with polyangiitis

SEOUL, South Korea – A research team at the Yonsei University College of Medicine reported in Seminars in Arthritis & Rheumatism that poor physical function at baseline is associated with premature death in patients with microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA)—2 conditions that fall under the umbrella of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).

While much research has been devoted to identifying risk factors in AAV for poor clinical outcomes (including mortality), the heterogeneity in the methodology used across the world makes it difficult for like-for-like comparison.

The 36-Item Short Form Health Survey (SF-36) has emerged as a reliable measure to determine quality of life and health status for various chronic diseases. It is unique in that it features both physical and mental components, as well as patient-reported outcomes.

Professors Sung Soo Ahn, Seok-Jae Heo and the other researchers hence sought to explore the association between SF-36 score and outcomes/mortality in patients with AAV. They recruited 189 patients with AAV and extracted and assessed their baseline clinical and laboratory data. The SF-36 was used to assess health-related quality of life (HRQoL).

The research team found that patients with mortality had higher levels of C-reactive protein (CRP) and lower SF-36 physical/mental components compared with those who survived. The physical component of the SF-36 score had a negative and weak correlation with baseline erythrocyte sedimentation rate (ESR), CRP, Birmingham vasculitis activity score (BVAS), and five-factor score (FFS); in contrast, the mental component of SF-36 had a significant but likewise weak correlation with the same parameters, save for ESR.

In the Cox hazard analysis, SF-36 physical component scores less than 53.75 was significantly correlated with patient mortality during follow-up; this association remained, even after variables such as body mass index and BVAS were entered into the multivariable model.

“In conclusion, our findings confirmed that SF-36 [physical component] scores at disease diagnosis enables the prediction of mortality in patients with MPA and GPA during follow-up.”  “Therefore, evaluating HRQoL measures may provide clinically valuable information for these specific population” professor Sung Soo Ahn said.

The study was co-authored by Sung Soo Ahn, Seok-Jae Heo, Jang Woo Ha, Yong-Beom Park and Sang-Won Lee.

 

Funding

This work was supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare (HI14C1324), Handok Inc., Seoul, Republic of Korea (HANDOK 2021-006), and CELLTRION PHARM, Inc. Chungcheongbuk-do, Republic of Korea (NCR 2019-6).

 

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