Monday 12 November 2012

Depression and fatigue are major problems in UK patients with Sjögren’s syndrome – revealed in new health status survey

The annual European League Against Rheumatism (EULAR) 2012 Congress took place in Berlin this year, and among the highlights was the following report on one of the UKPSSR research studies:

The first report on the health problems encountered by patients with primary Sjögren’s syndrome (PSS) indicates a significant burden in terms of impaired health status compared to the UK general population – with depression and fatigue being the key factors.

Presenting the details of a survey involving 620 patients with PSS, Dr Wan-Fai Ng, (Clinical Senior Lecturer, Musculoskeletal Research Group, Institute of Cellular Medicine, University of Newcastle-upon-Tyne) explained that the survey he and his colleagues carried out used EuroQol (EQ)-5D, an increasingly popular health-related quality of life instrument - but which has not until now been applied to patients with PSS.

Dr Ng said that EQ-5D provides a simple descriptive profile, a single index value for health status and a visual analogue score (VAS). “The key advantages of EQ-5D are that the instrument is preference-based, easy to complete and the value sets can be easily converted to quality adjusted life years (QALYs) to aid cost-utility analysis.”

The proportion of PSS patients reporting any problem in mobility (42.4%), self-care (16.9%), usual activities (56.7%), pain/discomfort (81.1%) and anxiety/depression (49.6%) were far higher than in the UK population as a whole (5.4%, 1.6%, 7.9%, 30.2% and 15.7%, respectively).

The mean VAS score in PSS patients was 59.9, compared to 81.3 for the general population, and further analysis showed that EQ-5D VAS correlated with many clinical features of PSS - most strongly with fatigue, depression and pain.

Among the laboratory measures, only immunoglobulin G (IgG) levels, paraproteins and propionylcarnitine (C3) correlated with EQ-5D VAS.

Dr Ng concluded: “Our data adds to the growing body of evidence that effective management of fatigue is key to improving the health status of PSS patients.”

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