Similar Impairments to HRQOL Seen in Patients With ANCA-Associated Vasculitides and RA

In patients with AAVs and those with RA, health-related quality of life was correlated with organ damage.

Compared with the general population, patients with ANCA-associated vasculitides (AAVs) and those with rheumatoid arthritis (RA) report lower health-related quality of life (HRQOL), according to study findings published in Rheumatology.

Whether the effect of AAVs on HRQOL is similar with that of other autoimmune inflammatory rheumatic diseases is unknown. Therefore, researchers sought to compare HRQOL in patients with AAVs vs those with RA, as well as the general population.

Cross-sectional data were collected from patient health records of 3 tertiary rheumatology centers in Greece.

The HRQOL was measured using the Short Form 36 (SF-36) Health Survey, which included both physical (PCS) and mental component summary scores (MCS). Disease activity was assessed using the Birmingham Vasculitis Activity Score version 3 (BVASv3) and Disease Activity Score in 28 joints (DAS28-ESR), while disease damage/functional impairment was assessed using the Vasculitis Damage Index (VDI) and Health Assessment Questionnaire (HAQ) among the AAV and RA groups, respectively.

A total of 137 patients (66 with AAVs and 71 with RA) were included in the study. Mean disease duration was 6 years. Active disease status was present in 27% of the AAV group and in 28.2% of the RA group. No significant differences in patient demographics or disease characteristics were found between the groups.  

Our study is one the few comparative studies in the literature showing that patients with AAVs have impaired HRQoL, similar to RA, which was more prominent in MPA patients and those with high organ damage scores.

According to PCS and MCS scores, patients with both AAVs and RA vs control participants reported lower HRQOL (all P <.05).

Among patients with AAVs, no correlation was found between disease activity and HRQOL, although lower HRQOL was associated with higher disease damage scores. Patients with microscopic polyangiitis (MPA) vs those with granulomatosis with polyangiitis (GPA) reported lower HRQOL, according to PCS scores (39.9±12.5 vs 48.3±10.4, respectively; P =.009).

Among patients with RA, HRQOL was correlated with disease activity and impairment/damage.

No overall significant differences in HRQOL, as measured by PCS and MCS scores, were found between patients with AAVs and RA. However, patients with RA reported lower HRQOL scores based on disease activity and impairment.

The study was limited by its cross-sectional design, the decision to not enroll new patients as healthy control participants, and the use of a generic rather than a specific questionnaire to evaluate HRQOL in AAV.

Researchers concluded, “Our study is one the few comparative studies in the literature showing that patients with AAVs have impaired [HRQOL], similar to RA, which was more prominent in [patients with] MPA and those with high organ damage scores. The more specific tools assessing [HRQoL] in [patients with] AAV such as AAV PRO need to be validated in larger patient populations whereas newer treatment strategies aiming to prevent organ damage in AAVs are urgently needed.”