SAT0637-HPR IMPAIRED HEALTH-RELATED QUALITY OF LIFE AND PHYSICAL FUNCTION IN NORWEGIAN PATIENTS WITH TAKAYASU ARTERITIS.
Authors: T. Garen, Ø. Palm, B. Gudbrandsson
Journal: Annals of the Rheumatic Diseases (2020)

Background: Takayasu arteritis (TAK) is a rare vasculitis of large vessels in young women. We have previously reported a point prevalence of 25.6/10 6 . The disease most prevalently limited to the aortic arch and its branches (Type 1) among North Europeans. Early symptoms of TAK include fever, myalgia and loss of appetite. Later, the inflammation of blood vessel may lead to irreversible vascular damage and ischemic symptoms with claudication of the extremities. We have recently found that TAK may reduce life expectancy, mainly due to cardiovascular complications. The median age among those deceased was only 58 years. These findings clearly indicate that TAK may have severe impact on the wellbeing of the patients and their physical capacity. It is widely accepted to include patients’ perspectives related to their health condition and treatment to better understand the burden of the disease and the impact on their daily life activities. However, studies of health-related quality of life (HRQol) in TAK has rarely been undertaken, and we are not aware of any studies from the Northern part of Europe. Objectives: (i)To compare HRQol in Norwegian TAK with age– and sex matched Norwegian normative data. (ii) To assess patients reported disease symptoms (iii). To evaluate the impact of disease symptoms on HRQol and functional status. Methods: Patients with TAK from “The Norwegian Systemic Connective Tissue Disease and Vasculitis Registry” (NOSVAR) were included. All patients had to fulfill the American College of Rheumatology classification criteria and/or the modified Ishikawa diagnostic criteria for TAK and return three sets of questionnaires: 1) The SF 36 was applied to measure HRQL. Age- and sex-matched normative data were obtained from a former study and consisted of 2471 randomly selected Norwegian citizens (1162 women) who were &gt;20 yrs. of age. 2) Questions from the Modified Health Assessment Questionnaire (MHAQ). 3) Patients answered questionnaires regarding disease symptoms, employment and assessment of general health status Disease duration was defined as the time from diagnosis to date of registration. Pearson correlation tests were used to explore associations between disease symptoms and HRQL. Results: A total of 33 female patients were included. Their mean age at diagnosis was 32 yrs. and they had a disease duration of median, 8,9 yrs. at inclusion. The SF-36 results adjusted for age, indicated significantly impaired HRQoL in the patients compared with normative data on 6 of eight subscales, with the largest differences observed for role physical (51 vs. 80, p &lt; 0.001) and general health (51 vs. 78, p&lt; 0.001) (Fig. 1). Symptoms of claudication in legs correlated strongly to moderately with activities as running or jogging 3 km (.538, p&lt;0.001), walking outdoor on flat ground (.542, p=0.002), climbing stairs (.564, p=0.001) and run errands and shop (.417, p=0.016) assessed by MHAQ. The most frequently reported symptoms were dyspnea at physical exertion (67%), claudication of arms (63%) and myalgia (55%). A moderate correlation was found between claudication of legs (-.572, p&lt;0.001), pain (VAS) (-.585, p&lt;0.001), fatigue (-.493 P&lt;0.002), dyspnea (-.471, p&lt;0.002) and physical function as reported in SF36. Similarly, a moderate negative correlation was present between pain (VAS) (-.553, p&lt;0.001), fatigue (VAS) (-.482, p&lt;0.002) and mental health in SF36. At the time of diagnosis, 89 % were employed, compared to only 21% at registration. Patients self-perceived health status was reported in 39 %, compared to 79% in a share of the Norwegian population aged 16 or over (The data from the EU Statistics on Income and Living Condiions(EU SILC). Conclusion: Patients with TAK reported reduced QoL compared to data from our general population. The most frequently reported disease symptoms were dyspnea at exertion, claudication of arms and myalgia. Pain, fatigue and dyspnea at exertion had a significant impact on HRQol. Claudication of legs correlated significantly with impaired walking activities reported in MHAQ. Disclosure of Interests: None declared