For antiphospholipid syndrome patients, lab results don’t always paint the full picture
Antiphospholipid syndrome is an autoimmune disease that preferentially affects women. Patients with APS are typically given different medications to reduce their risk of blood clotting and help normalize lab values such as platelet count. Despite this, patients sometimes internally feel that they are not doing as well as the numbers are showing.
A study conducted by University of Michigan Medicine titled “Predictors and Interrelationship of Patient-Reported Outcomes in Antiphospholipid Syndrome: A Cross-Sectional Study” published in the American College of Rheumatology’s ACR Open, researchers found that many patients perceived their physical and cognitive function to be less than optimal.
One hundred and thirty-nine APS patients at University of Michigan Health were each given three questionnaires upon arrival to an appointment with their APS physician. The questionnaires asked APS patients to rate their physical function, cognitive function, and pain intensity.
The study found that roughly half of patients had a physical function score of less than 45, suggesting at least mild self-perceived impairment in how one is able to carry out their day-to-day physical activity. Another important domain, cognitive function, is often not assessed from a patient self-report perspective. A pioneering effort in this study was to systematically assess the relationship between cognitive function and the quality of life. While the cognitive function questionnaires have not previously been deployed as widely as those for physical function (limiting a deep understanding of score interpretations), a quarter of patients with primary APS were assigned a cognitive score of less than 40, suggesting at least moderate self-perceived impairment in this area.
Interestingly, impairments in self-reported physical function and cognitive function, as well as higher pain intensity, were not only associated with clinical markers suggestive of more severe disease, but also with potentially modifiable lifestyle factors such as obesity and smoking status.
Unexpectedly, patients taking drugs typically prescribed for mental health, such as selective serotonin reuptake inhibitors, also reported worse physical and cognitive function and higher pain intensity. Struggles with mental health are common in patients with unpredictable autoimmune diseases like APS, although the impacts of mental health and associated medications have only rarely been studied in this condition.
