The modified Health Assessment Questionnaire (mHAQ) is a well-established patient-reported outcome measure in systemic sclerosis (SSc) studies that reflects how a patient functions in several categories of activities of daily living. This study analyzed clinical, demographic, and socioeconomic factors that predict mHAQ scores over time.
This study included 388 patients with baseline mHAQ scores from the Genetics versus Environment in Scleroderma Outcome Study (GENISOS) early disease cohort with mean disease duration of 2.5 and mean follow-up time of 3.9 years and median follow-up of 7.2 years. A total of 1,950 mHAQ measurements were analyzed. Baseline disease characteristics were recorded and the association of these characteristics with the mHAQ score was analyzed at baseline and longitudinally.
Lower income and education levels, older age and more severe skin involvement at enrollment were independent predictors of worse perceived functional disability over time (ie higher longitudinal mHAQ levels). Higher longitudinal modified Rodnan Skin Scores correlated with higher mHAQ scores while higher longitudinal forced vital capacity % predicted values correlated with lower mHAQ scores over time (p<0.001 for both univariable and multivariable analyses). Moreover, higher baseline mHAQ scores predicted higher mortality (hazard ratio: 1.29, CI: 1.09, 1.52, p=0.003).
This large, longitudinal study of early disease SSc demonstrates that severity of skin disease and socioeconomic factors such as educational level and income are important predictors of perceived functional disability in SSc. This article is protected by copyright. All rights reserved.