HRQoL goals may improve outcome in PAH
medwireNews: Health-related quality of life (HRQoL) before and during treatment for pulmonary arterial hypertension (PAH) is significantly associated with survival, Brazilian researchers report.
Therefore, achieving predetermined HRQoL scores, in this case the physical component score (PCS) of the Short-Form 36 Health Survey (SF-36), “might represent a specific goal to be reached in treatment-to-target strategies, as currently is recommended for PAH”, say Rogério Souza (University of Sao Paulo Medical School) and co-authors of the study.
They found that among 54 patients (83% women) with newly diagnosed PAH, those with a baseline PCS above the median value of 32 had significantly better survival rates than those with a lower baseline PCS score.
Similarly, patients with a PCS above the median value of 38, recorded after 16 weeks of specific PAH therapy, had significantly greater survival than those with a lower score at follow-up.
However, the absolute change in PCS after treatment was not associated with survival, “suggesting that achieving a specific PCS threshold is more important than improving the PCS itself to determine a better prognosis,” the researchers remark. They add that a similar pattern has previously been reported for the 6-minute walking test (6MWT).
In this study, the patients demonstrated a significantly improved 6MWT after 16 weeks of treatment, increasing from an average of 414 m at baseline to 440 m at follow-up.
The patients also reported significant improvements in each of the specific SF-36 domains, except for bodily pain, as well as in the combined PCS and mental component scores.
Writing in Health and Quality of Life Outcomes, Souza and colleagues comment that the mortality rate for PAH remains high, with a 5-year survival of 57%, despite recent advances in diagnostics and treatment.
They add that although there is a need to further improve treatment strategies, their findings “reinforce the significance of improving the HRQL for such a relentless and progressive disease.”
“While attempting to improve the HRQL and establishing harder endpoints for clinical therapy, it is possible that better survival rates might also be achieved”, the team concludes.
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By Laura Cowen, medwireNews Reporter