Health-related quality of life of daily-life-affected benign essential blepharospasm: Multi-center observational study

by Parima Hirunwiwatkul, Wajamon Supawatjariyakul, Supharat Jariyakosol, Supanut Apinyawasisuk, Jiruth Sriratanaban, Yuda Chongpison, Priya Jagota, Nipat Aui-aree, Juthamat Witthayaweerasak, Suwanna Setthawatcharawanich, Kitthisak Kitthaweesin, Niphon Chirapapaisan, Piyawadee Chaimongkoltrakul, Poramaet Laowanapiban, Linda Hansapinyo, Suthida Panpitpat, Sireedhorn Kurathong, Jirat Nimworaphan, Suntaree Thitiwichienlert, Kavin Vanikieti, Narong Samipak, Worapot Srimanan, Nattapong Mekhasingharak, Pareena Chaitanuwong

Purpose

To compare Thais’ health-related quality of life (HRQOL) and severity grading, efficacy and safety in daily-life-affected benign essential blepharospasm (BEB) patients at baseline and after Botulinum toxin type A (BTX-A) treatment.

Design

Prospective-observational study.

Participants

BEB patients with Jankovic rating scale (JRS) at least 3 in both severity and frequency graded from 14 institutes nationwide were included from August 2020 to June 2021.

Methods

Demographic data, HRQOL evaluated by the Thai version of EQ-5D-5L and NEI-VFQ-25 questionnaires, and severity grading score evaluated by Jankovic rating scale (JRS) at baseline, 1, and 3 months after the treatment were collected. The impact of the BTX-A injections and their complications were recorded.

Results

184 daily-life-affected BEB patients were enrolled; 159 patients (86.4%) had complete data with a mean age of 61.40±10.09 years. About 88.05% were female, and 10.1% were newly diagnosed. Most of the patients had bilateral involvement (96.9%) and 12.6% had history of BEB-related accident. After BTX-A treatment, HRQOL improved significantly in 4 dimensions of EQ-5D-5L, except self-care. The EQ_VAS (mean±SD) was 64.54±19.27, 75.13±15.37, 73.8±15.85 (p<0.001) and EQ-5D-5L utility score was 0.748±0.23, 0.824±0.19 and 0.807±0.19 at baseline, 1, 3 months after treatment, respectively. From NEI-VFQ-25, HRQOL also improved in all dimensions, except eye pain. The JRS improved in all patients. Self-reported minor adverse events were 22.6%, which mostly resolved within the first month.

Conclusion

Daily-life-affected BEB impacted HRQOL in most dimensions from both generic and visual-specific questionnaires. BTX-A treatment not only decreased disease severity, but also improved quality of life.