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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.