Patients With APS Have Greater Impairment in Physical and Cognitive Function

In patients with antiphospholipid syndrome (APS), although clinical features do not appear to be dominant drivers of patient-reported outcomes (PROs), the global antiphospholipid syndrome score (aGAPSS) was found to be associated with impairments in physical and cognitive function, according to results of a cross-sectional study published in ACR Open Rheumatology.

In an effort to better understand the effect of APS on quality of life, the researchers evaluated PROs among patients with persistently positive antiphospholipid antibodies (aPLs).

All participants completed the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function and Cognitive Function Short Forms, as well as the pain intensity rating.

The T-scores for physical function were categorized as mild impairment (T-score, <45), moderate impairment (T-score, 30-40), and severe impairment (T-score, <30). Self-perceived pain intensity was rated on a scale of 0 to 10, with 10 representing the maximum level of pain.

Of a total of 139 patients included in the study, 89 had primary APS, 21 had secondary APS, and 29 had persistent aPL without fulfilling clinical thrombotic or obstetric criteria for APS.

The average T-scores for physical and cognitive function were 45.4±9.2 and 48.6±11.6, respectively. The average pain intensity score was 3.0±2.6. Overall, 47% of the participants endorsed at least mild impairment in physical function. The mean physical function, cognitive function, and pain intensity scores did not differ between the diagnostic groups. Patients who endorsed more impairment on 1 measure also tended to endorse more impairment on another measure (Pearson r=0.43-0.59; P <.0001).

According to multivariate models, age, smoking, and the use of pain medications and serotonergic agents were all associated with impairment in at least 1 PRO domain. Further, the Damage Index for APS was significantly associated with both physical function (P =.0008) and cognitive function (P =.01), but not with pain intensity (P =.15).

Study limitations included the fact that the data were cross-sectional in nature and derived from a primarily White cohort. Further, there were a limited number of PROs that could be captured during routine clinical visits (eg, depression, fatigue, and sleep).

Study authors concluded, “Although an APS-specific PRO tool is not yet available, PROMIS holds promise as a clinically relevant instrument that may enhance our understanding of issues pertinent to patients with APS, allowing us to address their priorities and health concerns more effectively.”