Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


The Influence of Thrombovascular Events on the Quality of Life in APS and SLE Patients.

Balitsky,  Amaris K., Peeva,  Valentina, Su,  Jiandong, Yeo,  Erik, Landolt-Marticorena,  Carol, Gladman,  Dafna D., Urowitz,  Murray B.

Objective:

The antiphospholipid syndrome (APS) is defined by the presence of antiphospholipid antibodies (aPLs) with clinical manifestations such as: venous or arterial thrombosis or recurrent pregnancy complications. The syndrome is either primary, or secondary due to an underlying condition, most commonly systemic lupus erythematosus (SLE). The purpose of this study was to describe and compare the characteristics and quality of life (QoL) of patients with previous thrombovascular events (TE) to those with no TE. To analyze the data, we used t-tests and one-way ANOVAs with Bonferroni post-hoc tests.

Methods:

Five patient groups followed at the University of Toronto SLE and APS clinics were defined as patients with: 1) (PAPS) primary APS, 2) (SAPS) APS secondary to SLE, 3) (SLE+TE) SLE patients who had a TE, but do not have positive aPLs, (i.e., do not have APS), 4) (SLE-TE+aPL) SLE without TE, but with a persistent positive aPL defined as anticardiolipin antibody of IgG and/or IgM > 40 GPL or MPL, on two or more occasions, at least 12 weeks apart, 5) (SLE-TE) SLE without TE, and without aPL. QoL was determined using the mental component score (MCS) and the physical component score (PCS) of the Medical Outcomes Study Short Form 36 (SF-36) at the most recent visit. To analyze the data, we used t-tests and one-way ANOVAs with Bonferroni post-hoc tests.

Results:

The table summarizes the data and marks significant differences with an asterisk. Mean age at the time of the questionnaire completion was similar across the five groups, except for a younger average age (42.9 years) in the SLE-TE group (p<.05). A high majority of patients were female across all groups, with a smaller majority (60.5%) in the PAPS group. There were more venous TEs in the PAPS group (65.8%) compared to the SAPS group (30.8%); however, the overall number of patients with arterial and venous TEs was similar. Patients with arterial events (44.7±11.5) scored lower than patients with venous events (49.2±11.6) in the MCS score (t(149.5) =-2.4, p =.02); however there was no difference in PCS scores between arterial and venous TE. There was a difference in PCS scores across the five groups (F(4,897) = 3.33, p<.05); however there was no difference in MCS scores. Patients in the SLE+TE group showed lower scores compared to the PAPS and SLE-TE+aPL groups (table). SLE+TE patients also scored lower on a number of QoL subscales.

Conclusions:

It appears that the combination of two severe conditions, SLE and thrombotic events, has a more negative influence on reported PCS, compared to having SLE or APS alone. This influence was not seen for the MCS score.

GroupNAgeSex (% F)TE type (% v)MCSPCS
PAPS3847.5 ± 15.460.565.848.6 ± 12.543.5 ± 11.1*
SAPS3954.8 ± 15.092.330.847.1 ± 10.938.6 ± 13.8
SLE+TE7951.1 ± 15.884.850.646.0 ± 11.736.5 ± 12.15*
SLE-TE+aPL7951.1 ± 16.884.8n.a.47.3 ± 12.242.5 ± 13.8*
SLE-TE66742.9 ± 15.2*90.1n.a.46.9 ± 11.640.4 ± 12.2

To cite this abstract, please use the following information:
Balitsky, Amaris K., Peeva, Valentina, Su, Jiandong, Yeo, Erik, Landolt-Marticorena, Carol, Gladman, Dafna D., et al; The Influence of Thrombovascular Events on the Quality of Life in APS and SLE Patients. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :13
DOI: 10.1002/art.27783

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