Background/Purpose: The SLE Disease Activity Score (SLE-DAS) has been developed and validated in Italian patients with SLE. The objective of this study was to evaluate the effect of disease remission as defined by SLE-DAS on health-related quality of life (HRQoL) in Chinese patients with SLE.

Methods: Consecutive patients who fulfilled the 1997 ACR or 2012 SLICC criteria for SLE between March and May 2023 were recruited from our clinics. Participants were asked to complete the validated Chinese version of the LupusPRO (v1.8) HRQoL questionnaire and Fatigue Severity Score (FSS) before consultation. Attending physicians were asked to grade the SLE disease activity according to the Physicians’ Global Assessment (PGA [0-3]), SLE-DAS and SLEDAI-2K. Remission, mild, and moderate/severe disease activity of SLE was defined as SLE-DAS ≤2.08, < 2.08-≤7.64 and >7.64 respectively. SLE-DAS Boolean-based remission was defined as all clinical items of SLE-DAS equal to zero and prednisolone usage ≤5mg/day. The effects of SLE-DAS remission on LupusPRO were studied by statistical analyses.

Results: At interim, a total of 216 SLE patients were studied (age 45.8±13.6 years; 96.2% women; SLE duration 16.0±7.8 years). All were ethnic Chinese. At baseline visit, 84 (38.9%) patients had clinically active SLE, defined by a PGA score ≥0.5.Active organ manifestations, in decreasing order of frequency, were proteinuria (17.2%), mucocutaneous lesions (11.0%), leukopenia (7.9%), arthritis (4.7%) and thrombocytopenia (2.8%). The distribution of PGA score was: < 0.5 (60.6%); 0.5-1.0 (16.2%), ≥1.0-2.0 (19.0%) and 2.0-3.0 (3.70%).There were 135 (62.5%) patients who scored zero in the clinical SLEDAI-2K.A total of 135 (62.5%) patients had SLE-DAS≤2.08, and 132 (61.1%) patients achieved SLE-DAS Boolean-based remission; 34 (15.7%) and 47 (21.6%) patients, respectively, had SLE-DAS mild and moderate/severe activity. SLE-DAS correlated significantly with PGA (r=0.802, p< 0.001), SLEDAI-2K (r=0.798, p< 0.001) and LupusPRO score (r=-0.285, p< 0.001).Patients with SLE-DAS Boolean-based remission, compared to non-remission, had significantly higher total LupusPRO score (73.1±15.1 vs 65.9±17.4; p < 0.001), particularly in the domains of lupus symptoms (72.0±17.7 vs 61.5±20.7; p< 0.001), procreation (88.3±19.6 vs 76.8±28.9; p< 0.001), lupus medications (68.2±23.6 vs 58.2±28.2; p=0.003), physical health (81.2±18.9 vs 76.5±21.4; p=0.03), emotional (64.5±22.5 vs 57.0±25.3; p=0.01), and body image (80.3±22.7 vs 74.3±27.6, p=0.01).Similarly, significantly higher LupusPRO score was observed in patients who achieved clinical SLEDAI-2K=0 (vs >0) (72.7±15.4 vs 66.3±17.3; p=0.005) and PGA< 0.5 (vs ≥0.5) (73.5±15.4 vs 65.2±16.7; p< 0.001). SLEDAI-2K and PGA also correlated significantly with LupusPRO score (r=-0.247; p< 0.001; r=-0.265; p< 0.001 respectively), with similar correlation coefficients with the SLE-DAS.

Conclusion: SLE-DAS remission is associated with significantly better HRQoL in Chinese patients with SLE in this interim cross-sectional analysis.Similar performance of SLE-DAS was observed with the SLEDAI-2K and PGA.Further longitudinal studies on the sensitivity of the SLE-DAS to change in disease activity are in progress.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/effect-of-sle-das-remission-on-quality-of-life-in-patients-with-systemic-lupus-erythematosus-a-cross-sectional-validation-study/