Association of the Lupus Low Disease Activity State (LLDAS) with Health-Related Quality of Life

Vera Golder¹, Rangi Kandane-Rathnayake², Alberta Y. Hoi³, Molla Huq⁴, Worawit Louthrenoo⁵, Yuan An⁶, Zhanguo Li⁶, Shue Fen Luo⁷, Sargunan Sockalingam⁸, Chak Sing Lau⁹, Mo Yin Mok¹⁰, Aisha Lateef¹¹, Kate Franklyn³, Susan Morton¹², Sandra V. Navarra¹³, Leonid Zamora¹³, Yeong-Jian Wu⁷, Laniyati Hamijoyo¹⁴, Madelynn Chan¹⁵, Sean O'Neill¹⁶, Fiona Goldblatt¹⁷, Mandana Nikpour¹⁸, Eric F Morand³ and Asia Pacific Lupus Collaboration, ¹Southern Clinical School, Centre for Inflammatory Diseases, Monash University, Melbourne, Australia, ²Rheumatology, Monash University, Melbourne, Australia, ³Centre for Inflammatory Diseases, Monash University, Melbourne, Australia, ⁴Department of Medicine (Rheumatology), Melbourne University, Melbourne, Australia, ⁵Division of Rheumatology, Department of Internal Medicine, Chiang Mai University, Chiang Mai, Thailand, ⁶Peking University People's Hospital, Beijing, China, ⁷Chang Gung University, Taoyuan County, Taiwan, ⁸University of Malaya, Kuala Lumpur, Malaysia, ⁹Univ Dept of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong, ¹⁰Queen Mary Hospital, Hong Kong, Hong Kong, ¹¹Medicine/Rheumatology, National University Health System, Singapore, Singapore, ¹²Monash Health, Melbourne, Australia, ¹³Rheumatology, University of Santo Tomas Hospital, Manila, Philippines, ¹⁴University of Padjadjaran, Bandung, Indonesia, ¹⁵Tan Tock Seng Hospital, Singapore, Singapore, ¹⁶University of New South Wales, Sydney, Australia, ¹⁷Royal Adelaide Hospital, Adelaide, Australia, ¹⁸Melbourne University, Melbourne, Australia

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Disease Activity, Quality of life and systemic lupus erythematosus (SLE)

Session Information

Date: Monday, November 14, 2016

Title: Systemic Lupus Erythematosus – Clinical Aspects and Treatment - Poster II: Damage Accrual and Quality of Life

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Systemic lupus erythematosus (SLE) is associated with significant impairment of health-related quality of life (HR-QoL). Recently, meeting a definition of a Lupus Low Disease Activity State (LLDAS), analogous to low disease activity in rheumatoid arthritis, was preliminarily validated as associated with protection from damage accrual. The LLDAS definition has not been previously evaluated for association with patient reported outcomes. The objective of this study was to determine whether LLDAS was associated with better HR-QoL, and examine predictors of HR-QoL, in a large multiethnic, multinational cohort of SLE patients.

Methods: Data were collected prospectively from 1422 patients at a single visit and analysed cross-sectionally. Disease status was measured using the SLE disease activity index (SLEDAI-2K), physician global assessment (PGA) and SLICC-ACR damage index. HR-QoL was measured using the Medical Outcomes Study 36-item Short Form Health Survey (SF-36v2).

Results: Significant differences in SF-36 domain scores were found between patients stratified by ethnic group, education level, damage score, or by the presence of active musculoskeletal or cutaneous manifestations. In multiple linear regression analysis, Asian ethnicity (p<0.001), higher education level (p<0.001), younger age (p<0.001) and shorter disease duration (p<0.01) were significantly associated with better physical component scores (PCS). Musculoskeletal disease activity (p<0.001) was negatively associated with PCS, and cutaneous activity (p=0.04) was negatively associated with mental component scores (MCS). Disease damage was associated with worse PCS (p<0.001), but not MCS scores. Compared to patients not meeting criteria for LLDAS, patients in LLDAS had higher HR-QoL as measured by better PCS (p<0.001) and MCS (p<0.001) scores; this remained significant after adjustment for other variables.

Conclusion: Ethnicity, education, and disease damage affect HR-QoL. Musculoskeletal activity is associated with poor physical components of HR-QoL, and cutaneous activity is associated with poor mental components of HR-QoL. Patients in LLDAS have better HR-QoL than those who are not in LLDAS.

Disclosure: V. Golder, None; R. Kandane-Rathnayake, None; A. Y. Hoi, None; M. Huq, None; W. Louthrenoo, None; Y. An, None; Z. Li, None; S. F. Luo, None; S. Sockalingam, None; C. S. Lau, None; M. Y. Mok, None; A. Lateef, None; K. Franklyn, None; S. Morton, None; S. V. Navarra, None; L. Zamora, None; Y. J. Wu, None; L. Hamijoyo, None; M. Chan, None; S. O'Neill, None; F. Goldblatt, None; M. Nikpour, None; E. F. Morand, None.

To cite this abstract in AMA style:

Golder V, Kandane-Rathnayake R, Hoi AY, Huq M, Louthrenoo W, An Y, Li Z, Luo SF, Sockalingam S, Lau CS, Mok MY, Lateef A, Franklyn K, Morton S, Navarra SV, Zamora L, Wu YJ, Hamijoyo L, Chan M, O'Neill S, Goldblatt F, Nikpour M, Morand EF. Association of the Lupus Low Disease Activity State (LLDAS) with Health-Related Quality of Life [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/association-of-the-lupus-low-disease-activity-state-lldas-with-health-related-quality-of-life/. Accessed .

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