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Disability, fatigue, pain and their associates in early diffuse cutaneous systemic sclerosis: the European Scleroderma Observational Study.

Artikel i vetenskaplig tidskrift
Författare Sébastien Peytrignet
Christopher P Denton
Mark Lunt
Roger Hesselstrand
Luc Mouthon
Alan Silman
Xiaoyan Pan
Edith Brown
László Czirják
Jörg H W Distler
Oliver Distler
Kim Fligelstone
William J Gregory
Rachel Ochiel
Madelon Vonk
Codrina Ancuta
Voon H Ong
Dominique Farge
Marie Hudson
Marco Matucci-Cerinic
Alexandra Balbir-Gurman
Øyvind Midtvedt
Alison C Jordan
Wendy Stevens
Pia Moinzadeh
Frances C Hall
Christian Agard
Marina E Anderson
Elisabeth Diot
Rajan Madhok
Mohammed Akil
Maya H Buch
Lorinda Chung
Nemanja Damjanov
Harsha Gunawardena
Peter Lanyon
Yasmeen Ahmad
Kuntal Chakravarty
Søren Jacobsen
Alexander J MacGregor
Neil McHugh
Ulf Müller-Ladner
Gabriela Riemekasten
Michael Becker
Janet Roddy
Patricia E Carreira
Anne Laure Fauchais
Eric Hachulla
Jennifer Hamilton
Murat Inanç
John S McLaren
Jacob M van Laar
Sanjay Pathare
Susanna Proudman
Anna Rudin
Joanne Sahhar
Christine Serratrice
Tom Sheeran
Douglas J Veale
Claire Grange
Georges-Selim Trad
Ariane L Herrick
Publicerad i Rheumatology (Oxford, England)
Volym 57
Nummer/häfte 2
Sidor 370-381
ISSN 1462-0332
Publiceringsår 2018
Publicerad vid Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning
Sidor 370-381
Språk en
Länkar dx.doi.org/10.1093/rheumatology/kex...
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Adult, Cost of Illness, Disability Evaluation, Europe, Fatigue, etiology, physiopathology, Female, Fingers, Hand Strength, Health Surveys, Humans, Male, Pain, etiology, physiopathology, Prospective Studies, Scleroderma, Diffuse, complications, physiopathology, Severity of Illness Index, Skin Ulcer, etiology, physiopathology
Ämneskategorier Reumatologi och inflammation

Sammanfattning

Our aim was to describe the burden of early dcSSc in terms of disability, fatigue and pain in the European Scleroderma Observational Study cohort, and to explore associated clinical features.Patients completed questionnaires at study entry, 12 and 24 months, including the HAQ disability index (HAQ-DI), the Cochin Hand Function Scale (CHFS), the Functional Assessment of Chronic Illness Therapy-fatigue and the Short Form 36 (SF36). Associates examined included the modified Rodnan skin score (mRSS), current digital ulcers and internal organ involvement. Correlations between 12-month changes were also examined.The 326 patients recruited (median disease duration 11.9 months) displayed high levels of disability [mean (s.d.) HAQ-DI 1.1 (0.83)], with 'grip' and 'activity' being most affected. Of the 18 activities assessed in the CHFS, those involving fine finger movements were most affected. High HAQ-DI and CHFS scores were both associated with high mRSS (ρ = 0.34, P < 0.0001 and ρ = 0.35, P < 0.0001, respectively). HAQ-DI was higher in patients with digital ulcers (P = 0.004), pulmonary fibrosis (P = 0.005), cardiac (P = 0.005) and muscle involvement (P = 0.002). As anticipated, HAQ-DI, CHFS, the Functional Assessment of Chronic Illness Therapy and SF36 scores were all highly correlated, in particular the HAQ-DI with the CHFS (ρ = 0.84, P < 0.0001). Worsening HAQ-DI over 12 months was strongly associated with increasing mRSS (ρ = 0.40, P < 0.0001), decreasing hand function (ρ = 0.57, P < 0.0001) and increasing fatigue (ρ = -0.53, P < 0.0001).The European Scleroderma Observational Study highlights the burden of disability in early dcSSc, with high levels of disability and fatigue, associating with the degree of skin thickening (mRSS). Impaired hand function is a major contributor to overall disability.

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