title: Health-related quality of life in severe cryoglobulinaemic vasculitis and improvement after B-cell depleting therapy.
abstract: OBJECTIVE
  To study the health-related quality of life (HRQOL) in severe cryoglobulinaemic vasculitis (CV) associated with hepatitis C virus infection (HCV) and to describe the effect of rituximab on HRQOL.
  
  
  METHODS
  HRQOL was evaluated with the Medical Outcomes Study Short Form 36 (SF-36). Health Survey questionnaire was submitted to 15 patients with severe CV. SF-36 questionnaire was evaluated at baseline and after rituximab. Physical Health Composite Summary (PCS) and Mental Health Composite Summary (MCS) scores were calculated according to standard protocols, and normalised to healthy controls. SF-36 summary scores were compared with those of HCV positive patients without CV, and other vasculitis published in the literature. European Quality of Life-5 dimensions (EQ5D) scores were also derived.
  
  
  RESULTS
  Physical and mental domain scores were all reduced if compared with those of the healthy population, with physical domains being greatly affected. HRQOL of CV was comparable with HRQOL reported for the other small vessel vasculitis. The development of CV in HCV positive patients worsened PCS rather than MCS score. Birmingham Vasculitis Activity Score (BVAS) did not correlate with HRQOL, while the presence of peripheral neuropathy was associated with a worse HRQOL. Early rituximab treatment improved both PCS and MCS scores, with long-term effects.
  
  
  CONCLUSIONS
  PCS rather than MCS was affected in HCV positive patients when CV is present. Rituximab improved both physical and mental domains, thus supporting its use before antiviral therapy in severe HCV-related CV. The cost/benefits ratio of a sequential therapy may be supported.
authors.affiliation: Clinic of Rheumatology, Department of Medical and Biological Sciences (DSMB), University of Udine, Udine, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Quartuccio
authors.forename: M
authors.initials: M
authors.lastname: Isola
authors.forename: P
authors.initials: P
authors.lastname: Masolini
authors.forename: P
authors.initials: P
authors.lastname: Scaini
authors.forename: R
authors.initials: R
authors.lastname: Zani
authors.forename: A
authors.initials: A
authors.lastname: Tavoni
authors.forename: M
authors.initials: M
authors.lastname: Pietrogrande
authors.forename: S
authors.initials: S
authors.lastname: Bombardieri
authors.forename: S
authors.initials: S
authors.lastname: De Vita
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000191:economics / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000187:drug effects* / Q000276:immunology; D003362:Cost-Benefit Analysis; D003449:Cryoglobulinemia / Q000097:blood / Q000188:drug therapy* / Q000191:economics / Q000276:immunology / Q000503:physiopathology / Q000523:psychology; D016527:Drug Costs; D005260:Female; D006304:Health Status; D006526:Hepatitis C / Q000150:complications / Q000276:immunology / Q000821:virology; D006801:Humans; D007155:Immunologic Factors / Q000191:economics / Q000627:therapeutic use*; D008212:Lymphocyte Depletion / Q000191:economics / Q000379:methods*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D000069283:Rituximab; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014657:Vasculitis / Q000097:blood / Q000188:drug therapy* / Q000191:economics / Q000276:immunology / Q000503:physiopathology / Q000523:psychology
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab