Impact of disease activity patterns on health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE)
Objective To assess the impact of different disease activity patterns—long quiescent (LQ), chronically active (CA) and relapsing-remitting (RR)—on health-related quality of life (HRQoL) in a cohort of patients with systemic lupus erythematosus (SLE).Methods A retrospective, monocentric analysis of p...
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BMJ Publishing Group
2024-07-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/11/2/e001202.full |
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| author | Chiara Tani Marta Mosca Chiara Stagnaro Linda Carli Elena Elefante Viola Signorini Dina Zucchi Francesco Ferro Chiara Cardelli Luca Gualtieri Davide Schilirò |
| author_facet | Chiara Tani Marta Mosca Chiara Stagnaro Linda Carli Elena Elefante Viola Signorini Dina Zucchi Francesco Ferro Chiara Cardelli Luca Gualtieri Davide Schilirò |
| author_sort | Chiara Tani |
| collection | DOAJ |
| description | Objective To assess the impact of different disease activity patterns—long quiescent (LQ), chronically active (CA) and relapsing-remitting (RR)—on health-related quality of life (HRQoL) in a cohort of patients with systemic lupus erythematosus (SLE).Methods A retrospective, monocentric analysis of prospectively collected data. Adult SLE outpatients were enrolled between 2017 and 2021.For each year of follow-up, three disease activity patterns were defined: LQ if at each visit clinical Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Activity Index (SELENA-SLEDAI)=0, Physician Global Assessment (PGA)=0; CA if at each visit clinical SELENA-SLEDAI >0, PGA >0; RR if patients presented active disease in at least one visit during the observation period, interspersed with periods of remission. These patterns were applied to the year and the 3 years before enrolment.At enrolment, each patient completed: Short Form 36 (SF-36), Lupus Impact Tracker, Functional Assessment of Chronic Illness Therapy (FACIT), Hospital Anxiety and Depression Scale (HADS). The correlation between disease patterns and Patient-Reported Outcomes was analysed.Results 241 SLE patients were enrolled, of which 222 had complete clinical data for the 3-year period before enrolment. Both in the year and during the 3 years before enrolment, the most frequent disease pattern was the LQ (154/241 and 122/222 patients, respectively), followed by RR (53/241 and 92/222 patients, respectively) and CA (34/241 and 8/222 patients, respectively).At baseline, fibromyalgia, organ damage, age and daily glucocorticoid dose were associated with worse HRQoL.At the multivariable analysis, after adjusting for confounding factors, patients with LQ disease during the 3 years before enrolment presented a better physical HRQoL (SF-36 physical component summary, regression coefficient=3.2, 95% CI 0.51–5.89, p=0.02) and minor depressive symptoms (HADS-D, regression coefficient=−1.17, 95% CI −2.38 to 0.0.27, p=0.055), compared with patients with CA/RR disease.Conclusion A persistently quiescent disease may have a positive impact on patients’ physical HRQoL and on depressive symptoms. However, this condition appears insufficient to obtain a significant improvement in mental health, fatigue and disease burden among patients with SLE. |
| format | Article |
| id | doaj-art-1293692a47074bc5b1adbd0ceedb4501 |
| institution | OA Journals |
| issn | 2053-8790 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | BMJ Publishing Group |
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| series | Lupus Science and Medicine |
| spelling | doaj-art-1293692a47074bc5b1adbd0ceedb45012025-08-20T02:12:49ZengBMJ Publishing GroupLupus Science and Medicine2053-87902024-07-0111210.1136/lupus-2024-001202Impact of disease activity patterns on health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE)Chiara Tani0Marta Mosca1Chiara Stagnaro2Linda Carli3Elena Elefante4Viola Signorini5Dina Zucchi6Francesco Ferro7Chiara Cardelli8Luca Gualtieri9Davide Schilirò10Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy1 Department of Clinical and Experimental Medicine, University of Pisa, Pisa, ItalyRheumatology Unit, University of Pisa, Pisa, ItalyRheumatology Unit, University of Pisa, Pisa, ItalyRheumatology Unit, University of Pisa, Pisa, ItalyRheumatology Unit, University of Pisa, Pisa, ItalyRheumatology Unit, University of Pisa, Pisa, ItalyRheumatology Unit, University of Pisa, Pisa, ItalyRheumatology Unit, University of Pisa, Pisa, ItalyRheumatology Unit, University of Pisa, Pisa, ItalyRheumatology Unit, University of Pisa, Pisa, ItalyObjective To assess the impact of different disease activity patterns—long quiescent (LQ), chronically active (CA) and relapsing-remitting (RR)—on health-related quality of life (HRQoL) in a cohort of patients with systemic lupus erythematosus (SLE).Methods A retrospective, monocentric analysis of prospectively collected data. Adult SLE outpatients were enrolled between 2017 and 2021.For each year of follow-up, three disease activity patterns were defined: LQ if at each visit clinical Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Activity Index (SELENA-SLEDAI)=0, Physician Global Assessment (PGA)=0; CA if at each visit clinical SELENA-SLEDAI >0, PGA >0; RR if patients presented active disease in at least one visit during the observation period, interspersed with periods of remission. These patterns were applied to the year and the 3 years before enrolment.At enrolment, each patient completed: Short Form 36 (SF-36), Lupus Impact Tracker, Functional Assessment of Chronic Illness Therapy (FACIT), Hospital Anxiety and Depression Scale (HADS). The correlation between disease patterns and Patient-Reported Outcomes was analysed.Results 241 SLE patients were enrolled, of which 222 had complete clinical data for the 3-year period before enrolment. Both in the year and during the 3 years before enrolment, the most frequent disease pattern was the LQ (154/241 and 122/222 patients, respectively), followed by RR (53/241 and 92/222 patients, respectively) and CA (34/241 and 8/222 patients, respectively).At baseline, fibromyalgia, organ damage, age and daily glucocorticoid dose were associated with worse HRQoL.At the multivariable analysis, after adjusting for confounding factors, patients with LQ disease during the 3 years before enrolment presented a better physical HRQoL (SF-36 physical component summary, regression coefficient=3.2, 95% CI 0.51–5.89, p=0.02) and minor depressive symptoms (HADS-D, regression coefficient=−1.17, 95% CI −2.38 to 0.0.27, p=0.055), compared with patients with CA/RR disease.Conclusion A persistently quiescent disease may have a positive impact on patients’ physical HRQoL and on depressive symptoms. However, this condition appears insufficient to obtain a significant improvement in mental health, fatigue and disease burden among patients with SLE.https://lupus.bmj.com/content/11/2/e001202.full |
| spellingShingle | Chiara Tani Marta Mosca Chiara Stagnaro Linda Carli Elena Elefante Viola Signorini Dina Zucchi Francesco Ferro Chiara Cardelli Luca Gualtieri Davide Schilirò Impact of disease activity patterns on health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE) Lupus Science and Medicine |
| title | Impact of disease activity patterns on health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE) |
| title_full | Impact of disease activity patterns on health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE) |
| title_fullStr | Impact of disease activity patterns on health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE) |
| title_full_unstemmed | Impact of disease activity patterns on health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE) |
| title_short | Impact of disease activity patterns on health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE) |
| title_sort | impact of disease activity patterns on health related quality of life hrqol in patients with systemic lupus erythematosus sle |
| url | https://lupus.bmj.com/content/11/2/e001202.full |
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