Vol.22 No.6

Original Article

Improvement in health-related quality of life in MPO-ANCA-associated vasculitis patients treated with cyclophosphamide plus prednisolone: an analysis of 18 months of follow-up data from the JMAAV study

Authors

Machi Suka1 , Taichi Hayashi2 , Shigeto Kobayashi3 , Satoshi Ito4 , Wako Yumura5 , Shoichi Ozaki6

  • Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
  • Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
  • Division of Internal Medicine, Juntendo University Koshigaya Hospital, Koshigaya, Japan
  • Division of Rheumatology, Niigata Rheumatic Center, Niigata, Japan
  • Department of Nephrology, Jichi Medical University, Shimotsuke, Japan
  • Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
Received:

19 October 2011

Accepted:

17 January 2012

Published online:

4 February 2012

Full Text

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Abstract

Objectives To examine the improvement in health-related quality of life (HRQOL) in association with disease activity in myeloperoxidase (MPO)-antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis patients treated with cyclophosphamide plus prednisolone.
Methods According to the Japanese Patients with MPOANCA-Associated Vasculitis (JMAAV) study protocol, a total of 48 patients with newly diagnosed MPO-ANCAassociated vasculitis received a standardized cyclophosphamide plus prednisolone regimen, and their clinical courses were followed for 18 months following their entry into the study. Disease activity was assessed using the Birmingham Vasculitis Activity Score (BVAS) 2003. HRQOL was assessed using MOS Short-Form 36 (SF-36) v2. BVAS new/worse, BVAS persistent, and SF-36 domain scores (norm-based) were calculated for the 32 eligible patients.
Results The mean SF-36 domain scores were significantly lower than the Japanese general population norm. Stepwise multiple linear regression analysis showed that the presence of new or worsening features of the nervous system was significantly associated with a deterioration in physical function. During the 18 months of follow-up, there were significant improvements in BVAS new/worse and all SF-36 domains except for general health and role emotional.
Conclusion MPO-ANCA-associated vasculitis patients experienced a considerable deterioration in HRQOL. The standardized cyclophosphamide plus prednisolone regimen of the JMAAV study induced remission in the majority of patients, and the induction of remission accompanied a recovery in HRQOL.

Key words

Birmingham Vasculitis Activity Score (BVAS) - MOS Short-Form 36-Item Health Survey (SF-36) - MPO-ANCA-associated vasculitis - Japan