Health-related quality of life in patients with newly diagnosed antineutrophil cytoplasmic antibody-associated vasculitis

Abstract

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.