TY - JOUR
T1 - Predictors of Longitudinal Quality of Life in Juvenile Localized Scleroderma
AU - Ardalan, Kaveh
AU - Zigler, Christina K.
AU - Torok, Kathryn S.
N1 - Funding Information:
The authors thank Thomas Medsger, MD, and Thaschawee Arkachaisri, MD, for establishing the pediatric scleroderma clinic and registry at the University of Pittsburgh; Nicole Hershey for her help in accessing and analyzing the registry data and for comments on earlier drafts of the article; and Cody Caplinger, Christina Mihok, Cierra Leber, and Mary Lucas for assistance with maintenance of the NRCOS database.
PY - 2017/7
Y1 - 2017/7
N2 - Objective: Localized scleroderma can negatively affect children's quality of life (QoL), but predictors of impact have not been well described. We sought to identify predictors of QoL impact in juvenile localized scleroderma patients. Methods: We analyzed longitudinal data from a single-center cohort of juvenile localized scleroderma patients, using hierarchical generalized linear modeling (HGLM) to identify predictors of QoL impact. HGLM is useful for nested data and allows for evaluation of both time-variant and time-invariant predictors. Results: The number of extracutaneous manifestations (ECMs; e.g., joint contracture and hemifacial atrophy) and female sex predicted negative QoL impact, defined as a Children's Dermatology Life Quality Index score >1 (P = 0.019 for ECMs and P = 0.002 for female sex). As the time since the initial visit increased, the odds of reporting a negative QoL impact decreased (P < 0.001). Conclusion: Our results suggest that ECMs, sex, and time since initial visit are more predictive of QoL impact in localized scleroderma than cutaneous features. Further study is required to determine which ECMs have the most impact on QoL, which factors underlie sex differences in QoL in localized scleroderma, and why increasing the time since the initial visit appears to be protective. An improved understanding of predictors of QoL impact may allow for the identification of patients at risk of poorer outcomes and for the tailoring of treatment and psychosocial support.
AB - Objective: Localized scleroderma can negatively affect children's quality of life (QoL), but predictors of impact have not been well described. We sought to identify predictors of QoL impact in juvenile localized scleroderma patients. Methods: We analyzed longitudinal data from a single-center cohort of juvenile localized scleroderma patients, using hierarchical generalized linear modeling (HGLM) to identify predictors of QoL impact. HGLM is useful for nested data and allows for evaluation of both time-variant and time-invariant predictors. Results: The number of extracutaneous manifestations (ECMs; e.g., joint contracture and hemifacial atrophy) and female sex predicted negative QoL impact, defined as a Children's Dermatology Life Quality Index score >1 (P = 0.019 for ECMs and P = 0.002 for female sex). As the time since the initial visit increased, the odds of reporting a negative QoL impact decreased (P < 0.001). Conclusion: Our results suggest that ECMs, sex, and time since initial visit are more predictive of QoL impact in localized scleroderma than cutaneous features. Further study is required to determine which ECMs have the most impact on QoL, which factors underlie sex differences in QoL in localized scleroderma, and why increasing the time since the initial visit appears to be protective. An improved understanding of predictors of QoL impact may allow for the identification of patients at risk of poorer outcomes and for the tailoring of treatment and psychosocial support.
UR - http://www.scopus.com/inward/record.url?scp=85020248945&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85020248945&partnerID=8YFLogxK
U2 - 10.1002/acr.23101
DO - 10.1002/acr.23101
M3 - Article
C2 - 27696700
AN - SCOPUS:85020248945
VL - 69
SP - 1082
EP - 1087
JO - Arthritis Care and Research
JF - Arthritis Care and Research
SN - 2151-464X
IS - 7
ER -