Date: Monday, October 22, 2018
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: To explore, at an item-level, the effect of disease activity (DA) on disease specific health related quality of life (HRQoL) factors in systemic lupus erythematosus (SLE) patients using an item response theory (IRT) longitudinal model.
Methods: This prospective longitudinal multicenter French cohort followed SLE patients over 2 years. All patients fulfilled ACR 1997 SLE criteria. Disease specific HRQoL according to LupusQol and SLEQOL was collected every 3 months. DA according to SELENA-SLEDAI, and flare assessment according to SELENA-SLEDAI Flare Index (SFI) and organ-based revised SELENA-SLEDAI Flare Index (SFI-R) was evaluated every 6 months. Response to SLEQOL and LupusQoL items were compared between remitting and non-flaring patients, in the 18 months following a flare, using an IRT approach fitting a linear logistic model with relaxed assumptions for each dimension of the questionnaires. Parameters estimations for an item are interpreted as a difference in improvement measured by a given item according to QoL in given domain resulting in being remitting from a flare compared to patients with no flare. A parameter is considered statistically significant when different from 0 according to its 95% confidence interval.
Results: Between December 2011 and July 2015, 336 patients were included (89.9% female). Mean (SD) SELENA-SLEDAI score was 3.9(4.3). twenty-two percent were taking immunosuppressive drugs. Among patients remitting from an SFI-R muskuloskeletal flare (image 1), remission led to significant improvement in HRQoL among items of LupusQoL in the physical health and pain domains (going to the market, pain interference with the quality of sleep), and SLEQOL physical functioning, symptoms and treatment domains (walking 3 km, joint pain, fear of needles, inconvenience of clinic visits). SFI-R Cutaneous flares impacted items related to self-image issues and intimate relationships (anxiousness, attractiveness linked to skin rashes, being less interested in sex or sexual relationship). Patients HRQoL remained adversely impacted up to 18 months after a flare. LupusQoL Item “weight gain due to treatment” was negatively impacted after an ostearticular flare.
Conclusion: IRT analyses pinpoint HRQoL items most important to patients in specific situations. LupusQoL and SLEQOL items related to physical HRQoL (physical health, physical functioning and pain domains) were most influenced by muskuloskeletal or cutaneous flares.
To cite this abstract in AMA style: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, Devilliers H. Item Responses to Disease-Specific Quality of Life Questionnaires in the 18 Months Following a Flare in SLE: An Item Response Theory Analysis of a French Prospective Longitudinal Multicenter Study [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/item-responses-to-disease-specific-quality-of-life-questionnaires-in-the-18-months-following-a-flare-in-sle-an-item-response-theory-analysis-of-a-french-prospective-longitudinal-multicenter-study/. Accessed September 19, 2019.
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