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Abstract Number: 1673

Disease Specific Quality of Life in Patients with Lupus Nephritis

Chi Chiu Mok1, Sergio Toloza2, Berna Goker3, Ann E. Clarke4, S. Navarra5, Daniel J. Wallace6, Michael H. Weisman7 and Meenakshi Jolly8, 1Medicine, Tuen Mun Hospital, Hong Kong, Hong Kong, 2Hospital San Juan Bautista, San Fernando del Valle de Catamarca, Argentina, 3Department of Internal Medicine- Rheumatology, Gazi University School of Medicine, Ankara, Turkey, 4Division of Rheumatology, University of Calgary, Calgary, AB, Canada, 5University of Santo Tomas Hospital, Manila, Philippines, 6Rheumatology, Cedars-Sinai/David Geffen School of Medicine at UCLA, Los Angeles, CA, 7Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA, 8Rheumatology, Rush University Medical Center, Chicago, IL

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: lupus nephritis and quality of life

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Session Information

Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment: Biomarker, Translational and Nephritis Studies

Session Type: Abstract Submissions (ACR)

 

ACR-LN

 

 

Active LN

 

 

 

No

Yes

P value

No

Yes

P value

Age (yrs)

42.8 (13.6)

40.3 (13.1)

0.002

41.1 (13.1)

37.9 (12.9)

0.01

PGA

0.6 (0.6)

0.7 (0.8)

0.04

0.5 (0.5)

1.5 (0.9)

<0.001

Total SLEDAI

3.0 (3.4)

4.0 (4.9)

0.01

2.2 (2.7)

9.4 (5.9)

<0.001

Total SDI

0.7 (1.2)

1.1 (1.8)

<0.001

1.2 (1.8)

1.1 (1.8)

0.96

Lupus Symptoms

75.4(21.2)

76.5 (20.8)

0.32

78.4 (19.8)

70.3 (23.0)

<0.001

Medications

76.6 (26.5)

72.3 (25.7)

<0.001

73.7 (25.8)

67.9 (25.3)

0.01

Cognition

69.2 (27.3)

70.7 (24.9)

0.59

70.5 (25.0)

71.3 (24.6)

0.80

Procreation

88.4 (22.0)

84.5 (24.5)

<0.001

86.2 (23.5)

79.2 (27.1)

0.003

Physical Health

83.3 (21.9)

83.6 (22.1)

0.72

84.6 (21.1)

80.4 (24.8)

0.12

Emotional Health

64.0 (27.3)

63.3 (25.7)

0.50

65.0 (25.8)

58.2 (24.6)

0.005

Pain-Vitality

67.5 (26.3)

71.2 (24.2)

0.03

71.9 (24.5)

69.0 (23.2)

0.13

Body Image

79.0 (25.5)

80.0 (24.0)

0.91

81.3 (23.9)

75.6 (24.0)

0.002

Summary HRQOL

76.3 (17.1)

75.7 (16.6)

0.44

77.0 (16.3)

71.6 (16.8)

0.001

Desires-Goals

72.5 (25.7)

71.4 (25.4)

0.30

73.2 (24.8)

65.7 (26.6)

0.004

Social Support

65.7 (33.1)

67.6 (32.7)

0.30

66.1 (33.2)

72.4 (30.8)

0.06

Coping

65.0 (27.2)

64.9 (26.3)

0.87

63.8 (26.5)

68.5 (25.5)

0.08

Satisfaction with Treatment

64.0 (34.6)

64.1 (32.1)

0.54

60.5 (32.8)

75.7 (26.4)

<0.001

Summary Non HRQOL

66.8 (19.3)

66.9 (18.1)

0.94

65.8 (18.7)

70.3 (15.8)

0.02

Background/Purpose

Little is known about patient reported outcomes (PRO) in lupus nephritis (LN), and no studies using a  disease targeted PRO  tool have been undertaken thus far. Herein, we describe quality of life (QOL) among patients with LN using a valid and reliable disease targeted PRO measure (LupusPRO).

Methods

Cross sectional data obtained from patients with systemic lupus erythematosus (SLE) during psychometric evaluation studies of LupusPRO from various countries were compared between those: 1) with and without LN and 2) with active and inactive-LN.”  Data compared included demographics, disease characteristics, and LupusPRO constructs.  Presence of LN was present if listed among the ACR classification criteria (ACR-LN), while presence of active LN was based on presence of urinary casts, hematuria, proteinuria or pyuria in the disease activity assessment (SELENA-SLEDAI) performed at the time of the study visit. LupusPRO has Health related QOL (HRQOL) and non-HRQOL constructs. HRQOL domains include lupus symptoms, cognition, medication, procreation, physical health, emotional health, pain-vitality and body image. Non-HRQOL domains include desires-goals, social support, coping and satisfaction with care. Non-parametric tests were used to make comparisons, and p values ≤ 0.05 were considered significant.

Results

There were 1,259 SLE patients; ninety-four percent were women and their mean (SD) age was 41.7 (13.5) yrs. Five-hundred and thirty-nine had ACR-LN. These patients were younger, had greater disease activity (PGA, Total SELENA-SLEDAI) and damage (SLICC/ACR) than those without LN.. Summary HRQOL and non-HRQOL scores were similar in both groups; however, those with ACR-LN had significantly worse scores on medications and procreation domains, while those without ACR-LN had worse scores on Pain-Vitality domains (Table 1).

129/540 ACR-LN patients had active LN. Patients with active LN were younger, had significantly greater disease activity (PGA, Total SELENA-SLEDAI), worse HRQOL and non-HRQOL than patients with inactive LN. Specific domains scores adversely affected among active LN patients were lupus symptoms, medications, procreation, emotional health, body image and desires-goals (Table 1). Satisfaction with care was significantly higher among patients with active LN as compared to inactive LN patients.

Conclusion

LN adversely affects several specific QOL domains and physicians need to be aware of these concerns


Disclosure:

C. C. Mok,
None;

S. Toloza,
None;

B. Goker,
None;

A. E. Clarke,
None;

S. Navarra,

Pfizer,GSK,

8;

D. J. Wallace,
None;

M. H. Weisman,
None;

M. Jolly,
None.

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