Quality of life impairment in Behçet's disease and relationship with disease activity: a prospective study

Abstract

Our aim was to prospectively investigate the impact of Behçet's disease (BD), disease activity, and clinical and demographic characteristics on different aspects of quality of life (QoL) measured by the short-form (SF)-36 QoL scale. We administered the SF-36 to 37 consecutive BD patients in different moments of disease activity, and to 23 healthy controls (HC). The eight subcategories of the SF-36 underwent statistical analysis for identifying differences and correlations. Compared to HC, BD patients showed significantly lower mean scores in all SF-36 QoL subscales except mental health and role-emotional. Females showed a poorer QoL compared to males. Disease activity evaluated by the BD Current Activity Form inversely correlated with physical functioning (ρ = -0.68, p < 0.0001), bodily pain (ρ = -0.68, p < 0.0001), role-physical (ρ = -0.64, p < 0.0001), vitality (ρ = -0.64, p < 0.0001), general health (ρ = -0.64, p < 0.0001), social functioning (ρ = -0.50, p = 0.0002), mental health (ρ = -0.48, p = 0.0004), and role-emotional (ρ = -0.40, p = 0.003). Mucosal, central nervous system (CNS), musculoskeletal and ocular manifestations were the main factors that negatively affected QoL in BD. For ocular disease, physical functioning was significantly impaired in patients with panuveitis compared to other ocular manifestations (p = 0.0002). Best-corrected visual acuity was inversely correlated with social functioning (ρ = -0.53, p < 0.0001), role-physical (ρ = -0.48, p < 0.0001), bodily pain (ρ = -0.46, p = 0.02), and mental health (ρ = -0.43, p < 0.0001). Patients with BD have a poorer QoL compared to HC, particularly for women, while the decline of QoL is closely related to the overall disease activity of BD. Single organ involvements may affect independently specific SF-36 subscales, especially mucosal, CNS, musculoskeletal, and ocular manifestations.

Keywords: BDCAF; Behçet’s disease (BD); Disease activity; Quality of life (QoL); Uveitis.