Association of pruritus with quality of life and disability in systemic sclerosis

Abstract

Objective. To our knowledge, no studies have investigated the association of pruritus, which is present in almost half of patients with systemic sclerosis (SSc; scleroderma), with quality of life (QOL) and disability. The objective of this study was to investigate the association of pruritus with QOL and disability in SSc. Methods. We performed a cross-sectional, multicenter study of 578 SSc patients >1 year post-enrollment in the Canadian Scleroderma Research Group Registry. Patients reported whether they experienced pruritus during the past month on most days and underwent clinical histories and medical examinations. QOL was measured using the mental and physical component summary scores of the Short Form 36, and disability was measured with the Health Assessment Questionnaire disability index. The association of pruritus with QOL and disability was estimated using linear regression, controlling for sociodemographic and disease variables. Results. A total of 248 patients (43%) reported pruritus on most days. Patients with pruritus had significantly worse mental (Hedges's g ‫؍‬ ؊0.43; 95% confidence interval [95% CI] ؊0.59, ؊0.26) and physical function (Hedges's g ‫؍‬ ؊0.51; 95% CI ؊0.68, ؊0.34) and greater disability (Hedges's g ‫؍‬ 0.46; 95% CI 0.29, 0.63) than patients without pruritus. In multivariate analyses, controlling for age, sex, marital status, education, disease duration, skin score, number of tender joints, gastrointestinal symptoms, breathing problems, Raynaud's phenomenon, and finger ulcers, pruritus was independently associated with mental (P ‫؍‬ 0.017) and physical function (P ‫؍‬ 0.003), but not disability (P ‫؍‬ 0.112). Conclusion. Pruritus is common and associated with QOL in SSc. More attention to pruritus in SSc is needed, including its measurement, etiology, trajectory, and potential methods for intervention.

Psychosocial Aspects of Scleroderma

“…28 Pruritus Pruritus, or itch, is common in SSc and is associated with HRQL, even after controlling for sociodemographic and other SSc symptom variables. 29,30 Overall, 43% of 959 patients with SSc from a Canadian registry reported pruritus on most days in the last month. 31 This rate was slightly higher, but not statistically significant, among patients with early SSc (<5 years since onset of non-Raynaud symptoms, 46%) versus those with longer disease duration (5 years, 41%).…”

Pruritus Epidemiology and Quality of Life

“…Pruritic patients with systemic sclerosis had significantly worse mental and physical function and greater disability. In multivariate analyses controlling for demographic and disease variables, pruritus was independently associated with mental ( p ¼ 0.017) and physical function ( p ¼ 0.003) but not disability ( p ¼ 0.112) (El-Baalbaki et al 2010).…”

Itching in Patients with Chronic Hand Eczema: Data from the CARPE Registry

“…A cross-sectional study with patients affected by systemic sclerosis from Canada measured QoL according to the 36-Item Short Form Health Survey. Patients suffering from pruritus had a significantly greater negative impact on QoL than patients without pruritus [22]. A cross-sectional study in 13 European countries with 250 consecutive patients and 125 healthy controls demonstrated that patients reporting itch were more depressed than those without itch, had more anxiety and a larger impact on QoL measured by the DLQI [23].…”