title: Quality of life in patients with antiphospholipid syndrome is related to disease burden and anticoagulant therapy.
abstract: OBJECTIVE
  To evaluate health-related quality of life (HRQoL) in primary antiphospholipid syndrome (PAPS) and correlate it with a crude estimate of accrual organ damage, comorbidity (diabetes mellitus, hypertension and dyslipidemia) and treatment (oral anticoagulation, immunosuppressors and prednisone).
  
  
  METHODS
  We assessed HRQoL with the Short-Form 36 (SF-36) and the Lupus Quality of Life instrument (LupusQoL) and the disease burden with a modified Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR SDI). As controls we used SF-36 data from a Mexican general population within the same age range.
  
  
  RESULTS
  We included 50 PAPS patients (86% women), mean age 47.6 ± 14.5 years, median disease duration 9.4 years, median SLICC/ACR score of 1 point and 80% had thrombotic events. PAPS patients had lower HRQoL than controls. We found a positive correlation between SF-36 and LupusQoL (r = 0.85, P < 0.0001). The SLICC/ACR SDI correlated negatively with both LupusQoL and SF-36, specifically the peripheral vascular domain (r = -0.29, P = 0.03, for both). Patients on oral anticoagulants (n = 37) had lower LupusQoL, physical functioning, intimate relationships, burden to others and pain scores as well as a lower SF-36 physical functioning score. We did not find differences in HRQoL regarding comorbidities and other treatments.
  
  
  CONCLUSIONS
  HRQoL in PAPS was related to burden of the disease specifically at the vascular peripheral area and use of anticoagulants.
authors.affiliation: Department of Immunology and Rheumatology, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Hernández-Molina
authors.affiliation: Department of Immunology and Rheumatology, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
authors.forename: Itzel
authors.initials: I
authors.lastname: González-Pérez
authors.affiliation: Department of Immunology and Rheumatology, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
authors.forename: Carlos
authors.initials: C
authors.lastname: Pacheco-Molina
authors.affiliation: Department of Immunology and Rheumatology, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
authors.forename: Antonio R
authors.initials: AR
authors.lastname: Cabral
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage*; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D001777:Blood Coagulation / Q000187:drug effects*; D016022:Case-Control Studies; D015897:Comorbidity; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011241:Prednisone
keywords: APS; anticoagulation; quality of life; thrombosis