Abstract
Background Achieving Remission and LDAS are desirable states in lupus patients as they are associated with better long-term outcomes including less damage accrual, lower flare rates and lower disease activity. However, whether achieving Remission and LDAS also account for a better quality of life (QoL) has not been examined. We hypothesized that this will be the case. The aim was to determine whether the proportion of time patients achieve either Remission or LDAS is associated with a better QoL.
Methods SLE patients from a well-established multiethnic, multicenter US cohort were included. Remission and LDAS were defined as follows: Remission, SLAM score=0 and prednisone 5 mg/day and no immunosuppressants); LDAS not in remission, SLAM score 3, prednisone 7.5 mg/day, no immunosuppressants; the proportion of time patients were in these two states (combined) was the independent variable. The end-points were the physical and mental summary measures (PCS and MCS, respectively) and the individual subscales (Physical functioning: FP, Role Physical: RP, Bodily Pain: BP, General Health: GH, Vitality: VT, Social Functioning: SF, Role Emotional: RE and Mental Health: MH) of the Short Form (SF)−36 at the last available visit. Linear regression was used to estimate the association between the proportion of follow-up time in remission and LDAS and the SF-36 measures with and without adjustment for the following baseline variables: age, gender, racial/ethnic group, education, poverty, social support, abnormal illness behaviors, fibromyalgia, disease activity, damage and the baseline scores of the corresponding SF-36 summary measures and subscales.
Results Five-hundred and forty-two patients with complete data for the dependent, independent and confounding variables were included. These patients were predominantly women, and either of Caucasian, African American or Hispanic ancestry. Overall, the mean scores for the summary measures of the SF-36 were low (38.9 for the PCS and 43.4 for the MCS); for the individual subscales the scores varied between 40.4 for VT and 65.4 for MH. In the adjusted MV analysis, the percent of time on either Remission and LDAS was associated with better QoL after adjusting for potential confounders (table 1).
Conclusions The percent of time lupus patients stay on Remission or LDAS is associated with a better QoL as measured by summary measures and subscales of the SF-36.
Funding Source(s): None
