Date: Monday, October 22, 2018
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
To analyze variables associated with evolution of disease-specific health related quality of life (HRQoL) in systemic lupus erythematosus (SLE) patients.
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.
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.
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.
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 10). https://acrabstracts.org/abstract/factors-associated-with-specific-quality-of-life-evolution-in-sle-patients-a-french-prospective-longitudinal-multicenter-study/. Accessed December 3, 2021.
« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/factors-associated-with-specific-quality-of-life-evolution-in-sle-patients-a-french-prospective-longitudinal-multicenter-study/