Prospective Demonstration That Attainment of the Lupus Low Disease Activity State Is Associated with Improved Health Related Quality of Life

Vera Golder¹, Molla Huq ², Rangi Kandane-Rathnayake ³, Worawit Louthrenoo ⁴, Shue Fen Luo ⁵, Yeong-Jian Wu ⁵, Aisha Lateef ⁶, Sargunan Sockalingam ⁷, Sandra Navarra ⁸, Leonid Zamora ⁹, Laniyati Hamijoyo ¹⁰, Yasuhiro Katsumata ¹¹, Masayoshi Harigai ¹², Madelynn Chan ¹³, Sean O'Neill ¹⁴, Fiona Goldblatt ¹⁵, Chak Sing Lau ¹⁶, Zhanguo Li ¹⁷, Alberta Hoi ¹⁸, Mandana Nikpour ¹⁹ and Eric Morand ¹, ¹Monash University, Melbourne, Victoria, Australia, ²University of Melbourne, Melbourne, Australia, ³Monash University, Melbourne, Australia, ⁴Chiang Mai University Hospital, Chiang Mai, Thailand, ⁵Chang Gung Memorial Hospital, Guishan, Taiwan (Republic of China), ⁶National University Hospital, Singapore, Singapore, ⁷University of Malaya, Kuala Lumpur, Malaysia, ⁸University of Santo Tomas Hospital, Manila, Philippines, ⁹Santo Tomas Hospital, Manila, Philippines, ¹⁰Padjadjaran University, Bandung, Indonesia, ¹¹Tokyo Women's University, Tokyo, Japan, ¹²Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, Tokyo, Japan, ¹³Tan Tock Seng Hospital, Singapore, Singapore, ¹⁴University of New South Wales, Sydney, Australia, ¹⁵Royal Adelaide Hospital, Adelaide, Australia, ¹⁶Hong Kong University, Hong Kong, Hong Kong, ¹⁷Peking University People’s Hospital, Beijing, China (People's Republic), ¹⁸School of Clinical Sciences, Monash University, Meloburne, Victoria, Australia, ¹⁹St Vincent's Hospital, Melbourne; The University of Melbourne, Melbourne, Australia

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: quality of life and outcome measures, Systemic lupus erythematosus (SLE)

Session Information

Date: Wednesday, November 13, 2019

Title: 6W013: SLE – Clinical VI: Epidemiology, Diagnosis, & Outcomes (2882–2887)

Session Type: ACR Abstract Session

Session Time: 9:00AM-10:30AM

Background/Purpose: The Lupus Low Disease Activity State (LLDAS) is a treatment endpoint for SLE that has been shown in prospective validation studies to be associated with protection against disease flares and damage accrual. In addition to improved physician-measured outcomes, attainment of treatment endpoints should also result in improvement in patient-reported outcomes such as health related quality of life (HR-QoL). The objective of this study was to assess the effect of attainment of LLDAS on HR-QoL.

Methods: 1,735 SLE patients in 11 centres were prospectively recruited, and followed for (mean ± SD) 2.2 ± 0.9 years, totalling 12,717 visits. HR-QoL was captured using SF-36 at baseline and annually until completion of the study. At each visit LLDAS status was ascertained. Generalized estimating equations models were used to assess the association of LLDAS status with low SF-36 scores (threshold for low SF-36 based on the median across all visits). Time dependent Cox proportional hazard models were used to assess increasing proportion of cumulative time in LLDAS and protective association against low SF-36 scores.

Results: LLDAS attainment was observed in 6091 (47.9%) visits. LLDAS status was associated with a significant protective effect against low physical component summary scores (PCS, RR 0.88, 95% CI 0.84-0.94, p< 0.001) and low mental component summary scores (MCS, RR 0.90, 95% CI 0.86-0.95, p< 0.001). Increasing proportions of cumulative time in LLDAS were associated with graded protective effect against low PCS and MCS scores (table 1).

Conclusion: In this large prospective cohort study, LLDAS was significantly associated with protection from low HR-QoL, as measured by SF-36. Importantly, increasing cumulative time in LLDAS was associated with a dose dependent protective effect against low SF-36 scores, providing further validation for the use of LLDAS as a treatment endpoint in SLE.

Table 1

*Low threshold based on median score across all visits

Disclosure: V. Golder, None; M. Huq, None; R. Kandane-Rathnayake, None; W. Louthrenoo, None; S. Luo, None; Y. Wu, None; A. Lateef, None; S. Sockalingam, None; S. Navarra, Abbott, 8, Abbott, Astellas, Johnson & Johnson, Novartis, Pfizer, 8, Astellas, 8, Johnson & Johnson, 8, Novartis, 8, Pfizer, 8; L. Zamora, None; L. Hamijoyo, None; Y. Katsumata, None; M. Harigai, AbbVie Japan GK, 2, 8, Ayumi Pharmaceutical Co. Ltd., 2, Bristol Meyers Squib, 2, 5, 8, Bristol-Myers Squibb Co. Ltd, 2, 5, 8, Chugai Pharmaceutical Co. Ltd., 2, 5, 8, Chugai Pharmaceutical Co., Ltd., 2, 5, 8, Eisai Co. Ltd., 2, Eisai Co., Ltd., 2, Eli Lilly, 5, 8, Mitsubishi Tanabe Pharma Co., 2, Mitsubishi Tanabe Pharma Corp., 2, Nippon Kayaku Co. Ltd., 2, Taisho Toyama Pharmaceutical Co. Ltd., 2, Takeda Pharmaceutical Co., 2, Takeda Pharmaceutical Co., Ltd., 2, Teijin Pharma Ltd., 2, 8, Teijin Pharma, Ltd., 2, 8; M. Chan, None; S. O'Neill, None; F. Goldblatt, None; C. Lau, None; Z. Li, None; A. Hoi, Merck, 2; M. Nikpour, Actelion, 2, Arthritis Australia, 2, Australian Rheumatology Association, 2, Bayer, 2, BMS, 2, GSK, 2, Pfizer, 2, Roche, 2, Scleroderma Victoria and Australia, 2, St Vincent's Hospital Melbourne Research Endowment Fund, 2; E. Morand, AstraZeneca, 2, 5, 8, Bristol Myers Squibb, 2, Eli Lilly, 5, Janssen, 2, 5, Merck Serono, 2, 5, UCB, 2.

To cite this abstract in AMA style:

Golder V, Huq M, Kandane-Rathnayake R, Louthrenoo W, Luo S, Wu Y, Lateef A, Sockalingam S, Navarra S, Zamora L, Hamijoyo L, Katsumata Y, Harigai M, Chan M, O'Neill S, Goldblatt F, Lau C, Li Z, Hoi A, Nikpour M, Morand E. Prospective Demonstration That Attainment of the Lupus Low Disease Activity State Is Associated with Improved Health Related Quality of Life [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/prospective-demonstration-that-attainment-of-the-lupus-low-disease-activity-state-is-associated-with-improved-health-related-quality-of-life/. Accessed .

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