1. Health Assessment Questionnaire-Disability Index (HAQ-DI) use in modelling disease progression in diffuse cutaneous systemic sclerosis: an analysis from the EUSTAR database
- Author
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Allanore Y., Bozzi S., Terlinden A., Huscher D., Amand C., Soubrane C., Siegert E., Czirjak L., Carreira P. E., Hachulla E., Zanatta E., Li M., Airo P., Mendoza F. A., Rosato E., Distler O. Svetlana Agachi, Walid Ahmed Abdel Atty Mohamed, Paolo Airò, Sabine Adler, Juan Jose Alegre-Sancho, Yannick Allanore, Lidia P. Ananieva, Codrina Ancuta, Branimir Anic, Fabiola Atzeni, Gianluigi Bajocchi, Alexandra Balbir-Gurman, Marko Baresic, Radim Becvar, Laura Belloli, Vera Bernardino, Washington Bianchi, Breno Valdetaro Bianchi, Otylia Kowal Bielecka, Francesco Paolo Cantatore, Patricia E. Carreira, Ivan Castellví, Marco Matucci Cerinic, Carlo Chizzolini, Lorinda S. Chung, Bernard Coleiro, Maura Couto, Mary Ellen Csuka, Giovanna Cuomo, Maurizio Cutolo, László Czirják, Lorenzo Dagna, Nemanja Damjanov, Ellen De Langhe, Francesco Del Galdo, Carlos de la Puente, Christopher Denton, Y., Allanore, S., Bozzi, A., Terlinden, D., Huscher, C., Amand, C., Soubrane, E., Siegert, L., Czirjak, P. E., Carreira, E., Hachulla, E., Zanatta, M., Li, P., Airo, F. A., Mendoza, E., Rosato, Svetlana Agachi, Distler O., Ahmed Abdel Atty Mohamed, Walid, Airò, Paolo, Adler, Sabine, Jose Alegre-Sancho, Juan, Allanore, Yannick, Ananieva, Lidia P., Ancuta, Codrina, Anic, Branimir, Atzeni, Fabiola, Bajocchi, Gianluigi, Balbir-Gurman, Alexandra, Baresic, Marko, Becvar, Radim, Belloli, Laura, Bernardino, Vera, Bianchi, Washington, Valdetaro Bianchi, Breno, Kowal Bielecka, Otylia, Paolo Cantatore, Francesco, Carreira, Patricia E., Castellví, Ivan, Matucci Cerinic, Marco, Chizzolini, Carlo, Chung, Lorinda S., Coleiro, Bernard, Couto, Maura, Ellen Csuka, Mary, Cuomo, Giovanna, Cutolo, Maurizio, Czirják, László, Dagna, Lorenzo, Damjanov, Nemanja, De Langhe, Ellen, Del Galdo, Francesco, de la Puente, Carlo, Denton, Christopher, Publica, and University of Zurich
- Subjects
0301 basic medicine ,Longitudinal study ,lcsh:Diseases of the musculoskeletal system ,medicine.medical_treatment ,2745 Rheumatology ,HAQ-DI score ,computer.software_genre ,Severity of Illness Index ,0302 clinical medicine ,Quality of life ,Surveys and Questionnaires ,Medicine and Health Sciences ,Longitudinal Studies ,610 Medicine & health ,skin and connective tissue diseases ,Database ,Mortality rate ,10051 Rheumatology Clinic and Institute of Physical Medicine ,EUSTAR registry, Diffuse cutaneous systemic sclerosis, Health Assessment Questionnaire-Disability Index, HAQ-DI score ,2723 Immunology and Allergy ,Disease Progression ,Hemodialysis ,ARTHRITIS ,CLINICAL-TRIALS ,Research Article ,musculoskeletal diseases ,medicine.medical_specialty ,Diffuse cutaneous systemic sclerosis ,PREDICTING MORTALITY ,EUSTAR registry ,CLASSIFICATION ,03 medical and health sciences ,Internal medicine ,SCORE ,medicine ,Humans ,030203 arthritis & rheumatology ,2403 Immunology ,Scleroderma, Systemic ,business.industry ,Proportional hazards model ,Diffuse cutaneous systemic sclerosi ,Health Assessment Questionnaire-Disability Index ,Rheumatology ,Clinical trial ,030104 developmental biology ,Scleroderma, Diffuse ,Quality of Life ,FUNCTIONAL DISABILITY ,Observational study ,lcsh:RC925-935 ,Mitoxantrone ,business ,computer - Abstract
BackgroundPatients with diffuse cutaneous systemic sclerosis (dcSSc) have a poor prognosis. The importance of monitoring subjective measures of functioning and disability, such as the Health Assessment Questionnaire-Disability Index (HAQ-DI), is important as dcSSc is rated by patients as worse than diabetes or hemodialysis for quality of life impairment. This European Scleroderma Trials and Research (EUSTAR) database analysis was undertaken to examine the importance of impaired functionality in dcSSc prognosis. The primary objectives were to identify predictors of death and HAQ-DI score progression over 1 year. HAQ-DI score, major advanced organ involvement, and death rate were also used to develop a comprehensive model to predict lifetime dcSSc progression.MethodsThis was an observational, longitudinal study in patients with dcSSc registered in EUSTAR. Death and HAQ-DI scores were, respectively, analyzed by Cox regression and linear regression analyses in relation to baseline covariates. A microsimulation Markov model was developed to estimate/predict natural progression of dcSSc over a patient’s lifetime.ResultsThe analysis included dcSSc patients with (N = 690) and without (N = 4132) HAQ-DI score assessments from the EUSTAR database. Baseline HAQ-DI score, corticosteroid treatment, and major advanced organ involvement were predictive of death on multivariable analysis; a 1-point increase in baseline HAQ-DI score multiplied the risk of death by 2.7 (p p p ConclusionsHAQ-DI score and major advanced organ involvement were comparable predictors of mortality risk in dcSSc. Baseline mRSS and baseline HAQ-DI score were predictive of HAQ-DI score progression at 1 year, indicating a correlation between these endpoints in monitoring disease progression. It is hoped that this EUSTAR analysis may change physician perception about the importance of the HAQ-DI score in dcSSc.
- Published
- 2020