ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1396

Factors Associated with Specific Quality of Life Evolution in SLE Patients: A French Prospective Longitudinal Multicenter Study

Hervé Devilliers1, Marie Corneloup2, Francois Maurier3, Denis Wahl4,5, Geraldine Muller6, Olivier Aumaître7, Pascal Sève8, Gilles Blaison9, Jean-Loup Pennaforte10, Thierry Martin11, Nadine Magy12, Sabine Berthier13, Laurent Arnaud14, Abderrahmane Bourredjem15 and Zahir Amoura16, 1Service de Médecine Interne et Maladies Systémiques, CHU de Dijon, Dijon, France, 2Clinical epidemiology, Clinical investigation center, INSERM CIC-EC 1432, Dijon University Hospital, 21000 Dijon, France, 3Médecine interne, Hôpitaux Privés de Metz, Metz, France, 4CHU de Nancy, Vascular Medicine Division and Regional Competence Center For Rare Vascular And Systemic Autoimmune Diseases, Nancy, F-54000, France; Inserm, UMR_S 1116, Nancy, F-54000, France; Université de Lorraine, Nancy, F-54000, France, Nancy, France, 5CHU de Nancy, Vascular Medicine Division and Regional Competence Centre For Rare Vascular And Systemic Autoimmune Diseases; and UMR_S U1116 Research Unit, Nancy, France, 6Department of Internal Medicine and Systemic Diseases, Hôpital François Mitterrand, CHU de Dijon, Dijon, France, 7CHU Pitié-Salpêtrière - Department of Internal Medicine 2. Referal center for SLE/APS, Paris, France, 8Internal medicine, Internal medicine department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France, 9Internal medicine departement, Colmar Hospital, Colmar, France, 10Internal Medicine, Internal medicine departement, CHU de Reims, Reims, France, 11Cnrs UPR9021, Department of Clinical Immunology and Internal Medicine, Strasbourg University Hospital, IBMC CNRS UPR9021, Strasbourg, France, 12Internal Medecine, CHRU Besançon, Besancon, France, 13Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France, 14Department of Medicine, Rheumatology Unit, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden, 15Clinical investigation center, INSERM CIC-EC 1432, Dijon University Hospital, Dijon, France, 16Université Pierre et Marie Curie, Paris, France

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Date: Monday, October 22, 2018

Title: Patient Outcomes, Preferences, and Attitudes Poster I: Patient-Reported Outcomes

Session Type: ACR Poster Session B

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

Background/Purpose:

To analyze variables associated with evolution of disease-specific health related quality of life (HRQoL) in systemic lupus erythematosus (SLE) patients.

Methods:

We conducted a prospective longitudinal multicenter French cohort of SLE patients followed over 2 years. All patients fulfilled ACR 1997 SLE criteria. Disease-specific HRQoL was evaluated using Lupus Quality of Life (LupusQol) and Systemic Lupus Erythematosus Quality of Life (SLEQOL) every 3 months. Domain scores were rescaled from 0 to 100 (best HRQOL). Disease Activity (DA) and flare were recorded every six months utilizing SELENA-SLEDAI, SELENA-SLEDAI Flare Index (SFI) and revised SELENA-SLEDAI Flare Index (SFI-R). Each SLEQOL and LupusQoL domains’ scores evolution were explained by fitting a multivariate linear mixed model. For each independent variable, interaction with time was tested to see if was linked with a greater decline in HRQOL. Social deprivation is defined it as an unstable state concerning one or more basic securities (a job, health, family status) that prevented people from enjoying fundamental rights and that could lead to poverty. It was identified as having an EPICES score greater than 30.

Results:

Between December 2011 and July 2015, 336 patients were included (89.9% female). Mean (SD) SELENA-SLEDAI was 3.9(4.3). Twenty-two percent were taking immunosuppressive drugs. Each HRQoL domain was significantly impaired in patients with a poor social deprivation status (mean difference in HRQoL score ranging from -9 to -15, p<0.01 in all domains). Social deprivation was also associated with a greater decline in HRQOL scores across visits in two domains: LupusQoL Physical Health (p for interaction with time p=0.03) and fatigue (p for interaction with time: p=0.02). SFI flares were significantly associated with a decrease in the following domains of LupusQol Pain, Planning, Emotional Health and Burden to Others) and SLEQOL (Physical Functioning, Symptoms and Mood; p<0.05)

SFI-R muskulo-skeletal flares resulted in a significant decrease in all domains of the SLEQOL and LupusQoL (mean difference ranging from -5 to -15 points difference with p<0,01), interaction with time being significant in the LupusQoL Pain (-0.5 every 3 months, p=0.03) and SLEQOL Social Activities domain scores (-0.6 every 3 months, p<0.01). Corticosteroids daily dosage >10 mg was associated with significant decrease of the Body Image LupusQol score: -6 (p<0,05) without time interaction.

Conclusion:

Variation in disease activity, according to SFI and SFI-R, is associated with specific HRQoL evolution, independently of patient’s other characteristics. muskuloskeletal flares negatively impacted both disease specific HRQoL tools in SLE. Socio-economic status is a major risk factor of HRQoL decline for SLE patients and thereby should be recorded to allow a correct interpretation of HRQoL, and to identify those at risk, so that appropriate interventions can be targeted to those at risk.

Disclosure: H. Devilliers, GSK, 2; M. Corneloup, None; F. Maurier, None; D. Wahl, None; G. Muller, None; O. Aumaître, None; P. Sève, AbbVie Inc., 5,Novartis, 5; G. Blaison, None; J. L. Pennaforte, None; T. Martin, None; N. Magy, None; S. Berthier, None; L. Arnaud, GSK, 2, 5,AstraZeneca, 5,Roche, 5,Janssen, 5,Eli Lilly and Co., 5,Novartis, 5,UCB, Inc., 5; A. Bourredjem, None; Z. Amoura, None.

To cite this abstract in AMA style:

Devilliers H, Corneloup M, Maurier F, Wahl D, Muller G, Aumaître O, Sève P, Blaison G, Pennaforte JL, Martin T, Magy N, Berthier S, Arnaud L, Bourredjem A, Amoura Z. Factors Associated with Specific Quality of Life Evolution in SLE Patients: A French Prospective Longitudinal Multicenter Study [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/factors-associated-with-specific-quality-of-life-evolution-in-sle-patients-a-french-prospective-longitudinal-multicenter-study/. Accessed .

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