title: Longitudinal analysis of quality of life in patients with undifferentiated connective tissue diseases.
abstract: OBJECTIVE
  To prospectively assess the quality of life (QoL) of patients affected by undifferentiated connective tissue diseases (UCTDs) and to identify factors associated with changes over time.
  
  
  METHODS
  A total of 46 consecutive UCTD patients completed the Short-Form 36 (SF-36) questionnaire at presentation and then yearly. At each 6-month visit, all patients underwent a detailed history taking and a laboratory and physical assessment, in order to follow the evolution of the disease over time and to assess the the co-existence of fibromyalgia.
  
  
  RESULTS
  At presentation, scores lower than the average of the general population were detected in 34 (74%) and 41 (89%) patients in the physical and mental domains, respectively. No difference between patients with and without Raynaud's phenomenon was detected. Fibromyalgia was the only independent variable associated with an impaired physical component summary score (p= 0.0009). No patient feature was found to be associated with the basal mental component summary score. During 24 months of follow-up, a significant improvement (ie, a change ≥5 from baseline) in physical component summary and mental component summary scores was observed in 14 (33.3%) and 20 (43.4%) patients, respectively. Patients who significantly improved in the physical domain more frequently had a history of glucocorticoids intake (p<0.001), while those who improved in the mental component more frequently had a history of either glucocorticoids (p= 0.043) or immunosuppressors (p= 0.037) intake during follow-up.
  
  
  CONCLUSIONS
  UCTD patients perceive a worse QoL, regardless of Raynaud's phenomenon Fibromyalgia is one of the major contributors of physical QoL, whereas no factor influencing mental component has been identified. An improvement in QoL can be observed in less than half of patients over a 2-year follow-up. Larger studies are needed to identify factors influencing QoL and to define the role of pharmacological treatments.
authors.affiliation: Rheumatology Section, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Iudici
authors.affiliation: Rheumatology Section, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Irace
authors.affiliation: Rheumatology Section, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Riccardi
authors.affiliation: Rheumatology Section, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Cuomo
authors.affiliation: Rheumatology Section, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Vettori
authors.affiliation: Rheumatology Section, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Valentini
keywords: fibromyalgia; glucocorticoids; quality of life; undifferentiated connective tissue diseases