Health related quality of life, remission and low lupus disease activity state in patients with systemic lupus erythematosus.

ABSTRACT

OBJECTIVES: To measure the association between systemic lupus erythematosus (SLE) remission and scores of patients reported outcome measures (PRO). METHODS: We performed a prospective cohort study of SLE patients with a 2-year follow-up, recording LupusPRO, LupusQol, SLEQOL, and SF-36 questionnaires. Remission was defined as remission-off-treatment (ROFT) and remission-on-treatment (RONT) according to the DORIS consensus. Mixed models accounting for repeated measures were used to compare groups as follow ROFT and RONT versus no remission, and Lupus Low Disease activity state (LLDAS) versus no LLDAS. RESULTS: A total of 1478 medical visits and 2547 PRO questionnaires were collected during the follow-up from the 336 recruited patients. A between-group difference in PRO scores reaching at least 5 points on a 0-100 scale was obtained in the following domains "lupus symptoms" (LLDAS +5 points on the 0-100 scale, RONT +9 and ROFT +5), "lupus medication" (LLDAS +5, RONT +8 and ROFT +9), "pain vitality" (LLDAS +6, RONT +9 and ROFT +6) of LupusPRO, "role emotional" (LLDAS +5, RONT +8), "role physical" (RONT +7 and ROFT +7), "bodily pain" (RONT +6), "mental health" (RONT +5) and "social functioning" (RONT +6) of SF-36. In contrast, a between-group difference reaching at least 5 points was not achieved for any of the LupusQol and SLEQOL domains. CONCLUSIONS: RONT, ROFT, and LLDAS were associated with significant and clinically relevant higher quality of life in most PRO domains of LupusPRO (disease-specific) and SF-36 (generic) questionnaires, but not with LupusQol and SLEQOL disease-specific questionnaires.