Validity of the EQ‐5D in patients with pemphigus vulgaris and pemphigus foliaceus

• Published in: British journal of dermatology (1951) Vol. 180; no. 4; pp. 802 - 809
• Main Authors: Tamási, B., Brodszky, V., Péntek, M., Gulácsi, L., Hajdu, K., Sárdy, M., Szegedi, A., Bata‐Csörgő, Z., Kinyó, Á., Rencz, F.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.04.2019
• Subjects: Adult; Aged; Aged, 80 and over; Anxiety; Autoimmune diseases; Cross-Sectional Studies; Female; Health Status; Humans; Hungary; Male; Mental depression; Middle Aged; Pain; Pain - diagnosis; Pain - etiology; Pain Measurement - methods; Pemphigus; Pemphigus - complications; Pemphigus - diagnosis; Quality of Life; Questionnaires; Severity of Illness Index; Skin diseases; Surveys and Questionnaires; Young Adult; Hungary
• ISSN: 0007-0963; 1365-2133; 1365-2133
• DOI: 10.1111/bjd.16883

Summary Background No studies to date have employed the EuroQoL EQ‐5D questionnaire to assess health‐related quality of life (HRQoL) in patients with pemphigus. Objectives To evaluate the HRQoL of patients with pemphigus by the EQ‐5D and to analyse the convergent and known‐groups validity of the EQ‐5D in this patient population. Methods Between 2014 and 2017, a multicentre cross‐sectional study was carried out. Outcome measures included the five‐level EQ‐5D (EQ‐5D‐5L), Dermatology Life Quality Index (DLQI), Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and an average pain intensity visual analogue scale (VAS) for the past 3 months. Results In total, 109 consecutive patients with pemphigus participated in the study (mean age 57 years; 64% women). Among the EQ‐5D dimensions, the most problems were reported regarding pain/discomfort (50%), mobility (43%) and anxiety/depression (43%). No significant difference was found in mean EQ‐5D index scores between patients with pemphigus vulgaris and those with pemphigus foliaceus (0·81 vs. 0·86, P = 0·14). The mean EQ‐5D index scores of patients with limited, moderate, significant and extreme pemphigus were 0·88, 0·82, 0·72 and 0·67, respectively (P = 0·001). The number of comorbidities was associated with greater impairment in EQ‐5D index scores (P < 0·001). DLQI (rs = −0·62, P < 0·001) and the average pain intensity VAS (rs = −0·59, P < 0·001) more strongly correlated with the EQ‐5D index scores than did ABSIS (rs = −0·40, P < 0·001). Conclusions This is the first study employing the EQ‐5D questionnaire in pemphigus. The EQ‐5D is a valid measure of HRQoL in patients with pemphigus that can be useful both in clinical practice and in economic evaluations to assess the health gains associated with new effective treatments. What's already known about this topic? The detrimental impact of pemphigus on health‐related quality of life has been reported in the literature. No studies to date have used the EQ‐5D questionnaire in patients with pemphigus. What does this study add? This is the first study employing the EQ‐5D questionnaire in pemphigus. The EQ‐5D is a valid instrument for the evaluation of health‐related quality of life in pemphigus vulgaris and pemphigus foliaceus. Pain intensity, mucocutaneous involvement and comorbidities are important predictors of quality of life. What are the clinical implications of this work? The EQ‐5D might help physicians to understand better the health loss from pemphigus. Linked Comment: Sitaru. Br J Dermatol 2019; 180: 705. Respond to this article Plain language summary available online