Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Faculty of Health and Life Science, Northumbria University, Newcastle upon Tyne, UK.
J Intern Med. 2022 Jun;291(6):849-855. doi: 10.1111/joim.13451. Epub 2022 Jan 24.
Primary Sjögren's syndrome (pSS) is a chronic inflammatory condition, which presents with symptoms of dryness, pain, fatigue and often symptoms of anxiety and depression. Health-related quality of life (HRQoL) is significantly reduced in pSS and the direct and indirect health costs of pSS are substantial. This study aims to determine how symptom burden, disease activity and demographics associate with HRQoL longitudinally over a median of 24-month follow-up period in pSS.
Longitudinal EuroQoL-5 dimension (EQ-5D)-3L data from the Newcastle pSS cohort (n = 377) were evaluated using a survival analysis strategy. Kaplan-Meier and Cox proportional hazards analysis were performed using baseline Newcastle Sjogren's Stratification Tool (NSST) subgroup, EULAR Sjogren's Syndrome Patient Reported Index (ESSPRI), EULAR Sjogren's Syndrome Disease Activity Index (ESSDAI), disease duration, age and sex as covariates including polypharmacy and comorbidity score, where data were available (n = 191).
Of the 377 pSS participants analysed in this study, 16% experienced a decline in HRQoL to a health state comparable to or worse than death. NSST subgroup and ESSPRI score had a significant relationship with time to 'EQ-5D event', whereas baseline ESSDAI, age, disease duration and sex did not.
In pSS, symptom burden and to a great extent NSST subgroup, rather than systemic disease activity, has a significant relationship with HRQoL longitudinally. Improvements in symptom burden have the potential to produce significant impacts on long-term HRQoL in pSS.
原发性干燥综合征(pSS)是一种慢性炎症性疾病,表现为干燥、疼痛、疲劳,常伴有焦虑和抑郁症状。pSS 患者的健康相关生活质量(HRQoL)显著降低,pSS 的直接和间接健康成本巨大。本研究旨在确定在 pSS 中位 24 个月的随访期间,症状负担、疾病活动度和人口统计学因素如何与 HRQoL 进行纵向关联。
使用生存分析策略评估来自纽卡斯尔 pSS 队列(n = 377)的纵向欧洲五维健康量表(EQ-5D)-3L 数据。使用基线纽卡斯尔干燥综合征分层工具(NSST)亚组、欧洲抗风湿病联盟干燥综合征患者报告指数(ESSPRI)、欧洲抗风湿病联盟干燥综合征疾病活动指数(ESSDAI)、疾病持续时间、年龄和性别作为协变量(包括多药治疗和合并症评分,在数据可用的情况下[n = 191])进行 Kaplan-Meier 和 Cox 比例风险分析。
在本研究分析的 377 名 pSS 参与者中,16%的人经历了 HRQoL 下降到与死亡相当或更差的健康状态。NSST 亚组和 ESSPRI 评分与“EQ-5D 事件”时间有显著关系,而基线 ESSDAI、年龄、疾病持续时间和性别则没有。
在 pSS 中,症状负担,在很大程度上还有 NSST 亚组,而不是系统性疾病活动,与 HRQoL 具有显著的纵向关系。症状负担的改善有可能对 pSS 的长期 HRQoL 产生重大影响。