M. V. Sheyanov, I. S. Shchedrina

Impact of pulmonary disorders on health-related quality of life in patients with rheumatoid arthritis

To study the influence of pulmonary manifestations of rheumatoid arthritis on health-related quality of life in patients. Health-related quality of life was measured with the use of a general (EQ-5D) and respiratory-specific (SGRQ) questionnaires in 104 non-smoking patients with rheumatoid arthritis and 100 controls who underwent in-patient medical evaluation for different reasons and were found to have no rheumatoid arthritis and chronic pulmonary disorders.

General clinical evaluation, comprehensive pulmonary function testing, and multidetector CT of the lungs were also performed. Patients with rheumatoid arthritis had worse scores on all dimensions of both questionnaires compared to controls. The quality of life scores significantly correlated in them to the presence and severity of clinical and functional manifestations of pulmonary involvement. EQ-5D index in persons with rheumatoid arthritis corresponded directly to both vital capacity (r=0.47, p<0.001) and carbon monoxide diffusing capacity of the lungs (r=0.67, p<0.01) giving low quality of life scores in patients with interstitial pulmonary fibrosis and significantly decreased above-mentioned pulmonary function indices.

Impaired physical tolerance due to dyspnea and associated psychosocial dysfunction were the main factors contributing to the decrease of health-related quality of life in patients with rheumatoid arthritis as assessed by SGRQ questionnaire. Multifactorial origin of dyspnea with pulmonary involvement, anemia, and emotional distress (anxiety and/or depression) playing independent roles was revealed. Pulmonary involvement impairs significantly the health-related quality of life in patients with rheumatoid arthritis.