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.
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 November 20, 2019.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/prospective-demonstration-that-attainment-of-the-lupus-low-disease-activity-state-is-associated-with-improved-health-related-quality-of-life/