Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Sanz, A.
Exploring primary Sjögren's Syndrome: A prospective cohort study on quality of life
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2021. pp. 70
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Lackner Angelika
- Stradner Martin Helmut
- Altmetrics:
- Abstract:
- Introduction/Objectives: Patients suffering from primary Sjögren’s Syndrome (PSS) are not only facing physical but also psychosocial challenges that can result in a decrease in health-related quality of life (HRQL). The aim of this study was to investigate possible factors that influence the course of the disease and to discover if there are any biomarkers that reflect the patient’s subjective well-being. In addition an attempt was made to find out what objective and subjective tests for sicca symptoms correlate the most. Methods: Data of patients from the rheumatology outpatient clinic of the Medical University of Graz fulfilling the 2016 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for PSS were obtained. Patient-reported outcomes were quantified using the PSS-QoL, EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), Xerostomia Inventory (XI), Ocular Surface Disease Index (OSDI), and the Profile of Fatigue and Discomfort – Sicca Symptoms Inventory (ProFaD-SSI). Sicca signs were measured using the Schirmer's test, Saxon test and the unstimulated salivary flow rate. Also, the EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI) was obtained. Serum IgG levels, rheumatoid factors (RF) IgA and IgM and various other labaratory parameters were determined. Results: Data of 107 patients were analyzed. 93.5% of the patients were female (n=100), the mean age was 60.31 (±12.23) years and the median disease duration was 6 [0-23] years. The PSS-Qol/physical showed the highest median in the age group “50-59” (17 [8-32]), whereas the PSS-QoL/psychosocial showed the highest median in the age group “older than 70” (25.5 [6-43]). Longitudinal data of PSS-QoL, ESSPRI and ESSDAI over two years were available from 52 patients. Only the ESSPRI/fatigue domain showed a significant change over a period of two years (from 3.4 to 4.5, p=0.013). 69.7% of the patients experienced no change of clinical importance regarding their PSS-QoL total scores. 8.3% of the patients felt physically worse, while 20.6% experienced more psychosocial difficulties than two years before. The PSS-QoL total score negatively correlated with IgG (ρ=-0.261, p<0.01) and RF IgA (ρ=-0.408, p<0.01). RF IgA also negatively correlated with the physical domain of the PSS-QoL (ρ=-0.307, p<0.01) and the ESSPRI (ρ=-0.260, p<0.05), while IgG negatively correlated with the psychosocial domain of the PSS-QoL (ρ=-0.245, p<0.05). The ProFaD-SSI/mental fatigue domain negatively correlated with IgG (ρ=-0.267, p<0.01) and RF IgA (ρ=-0.358, p<0.01). The Saxon test negatively correlated with all three immunological parameters, but especially with RF IgM (ρ=-0.607, p<0.01). Discussion: It appears that throughout the course of the disease, the psychosocial burden increases more rapidly than the physical one, so psychological care should be part of a more holistic therapy approach. Future studies involving healthy control groups are necessary to eliminate possible cofactors like comorbidities, which have a higher prevalence in certain age groups. The quantity of serum rheumatoid factors and IgG positively and negatively correlated with different objective and subjective measures and their use as biomarkers should be investigated in future studies.