Background LDAS is an achievable goal in the treatment of SLE patients and it is associated with a lower probability of flares, damage and mortality; whether HRQoL is also influenced hy LDAS has only been evaluated cross-sectionally but not longitudinally. The aim of this study was to determine if achieving LDAS predicts a better HRQoL
Methods SLE patients from a single center cohort with at least two visits were included. Visits were performed every six months. HRQoL was measured with the LupusQoL, disease activity with the SLEDAI-2K, damage with the SLICC/ACR damage index (SDI) and comorbidities with the Charlson Comorbidity Index (CCI). LDAS was defined as a SLEDAI-2K4, prednisone daily dose 7.5 mg/d and immunosuppressive drugs on maintenance dose; patient on remission were also included in this group. Generalized estimating equations were performed, using as outcome each one of the eight components of the LupusQoL in the subsequent visit, and the activity state in the previous visit; as possible confounders, we included disease duration, SDI, CCI, antimalarial use on each visit and age at diagnosis, gender, socioeconomic status and the same component of the LupusQoL at the baseline visit.
Results Two hundred and forty-three patients were included, 225 (92.6%) were female, mean age at diagnosis was 35.44 (SD: 13.13) years. Patients had a mean of 3.94 (1.98) visits for a total of 958 visits. During the follow-up, 590 (61.6%) visits were categorized as LDAS. LDAS predicted a better HRQoL in the components of physical health [B: 4.17 (95% CI: 1.20; 7.14); p=0.006], pain [B: 6.47 (95% CI: 3.18; 9.76); p<0.001], planning [B: 4.97 (95% CI: 1.43; 8.52); p=0.006], burden to others [B: 4.12 (95% CI: 0.24; 8.01); p=0.037], emotional health [B: 4.50 (95% CI: 1.56; 7.44); p=0.003] and fatigue [B: 3.25 (95% CI: 0.04; 6.47); p=0.048], as is depicted in table 1.
Conclusions Being on LDAS predicts a better HRQoL, especially in the components of physical health, pain, planning, burden to others, emotional health and fatigue.
Funding Source(s): The Almenara Lupus Cohort is partially supported by three institutional grants from EsSalud (1483-GCGP-ESSALUD-2013, 1733-GCGP-ESSALUD-2014 and the 2015 Kaelin Prize 2015) and one from the Panamerican League of Associations for Rheumatology (PANLAR) (2015 PANLAR Prize).
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