Perceived functioning has ethnic-specific associations in systemic sclerosis: another dimension of personalized medicine.
OBJECTIVE
To measure self-reported physical and mental functioning and associated clinical features at study entry in 3 ethnic groups with systemic sclerosis (SSc).


METHODS
Sixty Hispanic, 39 African American, and 104 Caucasian patients with recent-onset SSc (< 5 yrs) were assessed for perceived physical and mental functioning, using the Medical Outcomes Study Short Form-36 (SF-36) and Scleroderma-Health Assessment Questionnaire (Scleroderma-HAQ). Socioeconomic, demographic, clinical, immunologic, immunogenetic, behavioral, and psychological variables (Interpersonal Support Evaluation List, ISEL; Illness Behavior Questionnaire, IBQ; and Arthritis Helplessness Index, AHI) were analyzed by linear regression models for associations with SF-36 and mHAQ scores as dependent variables.


RESULTS
Perceived physical functioning scores had ethnic-specific associations with AHI > fatigue scores > IBQ > clinical variables (hypertension, skin score, and percentage predicted DLCO). Scleroderma-HAQ scores had ethnic-specific associations with IBQ > AHI scores > most clinical and laboratory variables. Decreased mental component summary (MCS) scores associated with AHI > ISEL. Ethnic-specific immunogenetic variables HLA-DQB1*0202 (Caucasian) and HLA-DRB 1*11 (African American), and HLA-DQA1*0501 (Hispanic) also associated with MCS. Antinuclear autoantibodies, anti-topoisomerase I, and RNA polymerases I and III also demonstrated associations with functioning in African American and Hispanic groups.


CONCLUSIONS
Clinical, psychosocial, and immunogenetic variables had ethnic-specific associations with perceived physical and mental functioning. Consideration of ethnic-specific psychological and behavioral support in designing more personalized, relevant therapeutic interventions for the patient may improve therapeutic efficacy in SSc.
McNearney
Terry A
TA
Department of Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, Texas 77555-1165, USA. tmcnearn@utmb.edu
Hunnicutt
Sonya E
SE
Fischbach
Michael
M
Friedman
Alan W
AW
Aguilar
Martha
M
Ahn
Chul W
CW
Reveille
John D
JD
Lisse
Jeffrey R
JR
Baethge
Bruce A
BA
Goel
Niti
N
Mayes
Maureen D
MD
D001741:Black or African American / Q000235:genetics / Q000523:psychology*; D001294:Attitude to Health; D004185:Disability Evaluation; D005260:Female; D006683:HLA-DQ Antigens / Q000276:immunology; D015438:Health Behavior; D006630:Hispanic or Latino / Q000235:genetics / Q000523:psychology*; D006801:Humans; D057285:Precision Medicine; D011788:Quality of Life / Q000523:psychology; D015203:Reproducibility of Results; D012595:Scleroderma, Systemic / Q000276:immunology / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D044465:White People / Q000235:genetics / Q000523:psychology*
D006683:HLA-DQ Antigens