Abstract
BackgroundFew studies have evaluated the relation of quality of life (QoL) with symptoms and disease activity in primary Sjögren’s syndrome (pSS). There is also scant information on the predictors of QoL in this population. The aim of this study was to assess QoL in patients with pSS and to investigate their possible predictors.MethodsIn a cross-sectional study, 77 patients with pSS were evaluated using the following questionnaires: Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-Fatigue), EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI), EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI), Short Form-36 Health Survey (SF-36) and World Health Organization Quality of Life Assessment (WHOQOL-BREF). Seventy-seven healthy controls responded to the SF-36 and WHOQOL-BREF. The Mann-Whitney test, t-test, Pearson and Spearman correlation, and multiple regression analysis were used in the statistical analysis.ResultsPatients with pSS and healthy controls were matched by gender and age. The mean scores for the ESSDAI, ESSPRI and FACIT-Fatigue were 3.34 ± 4.61, 6.58 ± 2.29 and 26.17 ± 11.02, respectively. Patients had a lower employment rate (36.4% versus 62.3%, p < 0.01) and higher work disability (10.4% versus 1.3%, p < 0.01). SF-36 and WHOQOL-BREF values were lower in patients with pSS (p < 0.001), except in the WHOQOL-BREF environment domain. Pain (ESSPRI), fatigue (FACIT-Fatigue), antinuclear antibody (ANA), anti-Ro-SSA and economic class (Brazilian Economic Classification Criteria - CCEB) were independent predictors of QoL.ConclusionsThe main predictors of poor QoL in patients with pSS were pain and fatigue, and these symptoms had an impact regardless of disease activity, age, schooling, marital status, work disability and fibromyalgia.
Highlights
Primary Sjögren syndrome is an autoimmune, chronic and systemic disease that causes an inflammatory lymphocyte infiltrate with dysfunction of the salivary and lacrimal glands, leading to xerostomia and xerophthalmia
The patients presented a high level of symptoms (ESSPRI 6.58 ± 2.29)
Omma et al found that the EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI) was an independent determinant of all Short Form-36 Health Survey (SF-36) domains, with the exception of the vitality domain, in 105 patients from Turkey, most of whom had low to moderate levels of disease activity [36]
Summary
Primary Sjögren syndrome (pSS) is an autoimmune, chronic and systemic disease that causes an inflammatory lymphocyte infiltrate with dysfunction of the salivary and lacrimal glands, leading to xerostomia and xerophthalmia. Epigenetic mechanisms such as DNA demethylation in epithelial cells and altered expression of microRNAs in salivary glands act on genetically susceptible patients, leading to the Fatigue, a physical or mental feeling of tiredness, affects approximately 70% of these patients and is strongly associated with psychosocial factors, occupational dysfunction and a greater number of medical visits but not with sicca severity or laboratory features [5, 6]. The aim of this study was to assess QoL in patients with pSS and to investigate their possible predictors
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