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Disease activity and quality of life in patients with systemic lupus erythematosus: a validation study using the SLE-DAS


1, 2, 3, 4

 

  1. Department of Medicine, Pok Oi Hospital, Hong Kong (SAR), China.
  2. Department of Medicine, Tuen Mun Hospital, Hong Kong (SAR), China.
  3. Department of Medicine, Pok Oi Hospital, Hong Kong (SAR), China.
  4. Department of Medicine, Tuen Mun Hospital, Hong Kong (SAR), China. ccmok2005@yahoo.com

CER18188
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PMID: 40095632 [PubMed]

Received: 26/09/2024
Accepted : 10/02/2025
In Press: 13/03/2025

Abstract

OBJECTIVES:
To study the relationship between disease activity and quality of life (QoL) in patients with systemic lupus erythematosus (SLE) using the SLE disease activity score (SLE-DAS).
METHODS:
Consecutive patients fulfilling the ACR/SLICC criteria for SLE were recruited. Participants were asked to complete the validated Chinese version of the LupusPRO for QoL evaluation before disease activity assessment by SLE-DAS, SLE disease activity index (SLEDAI)-2K and Physician Global Assessment (PGA). Correlation between disease activity and LupusPRO scores, and the effect of SLE-DAS remission on QoL was studied. Patients with active SLE at baseline, defined as a PGA≥0.5, were re-evaluated after 6 months. The change in LupusPRO score was correlated with the change in SLE-DAS.
RESULTS:
A total of 510 patients were studied (92.9% women; age 48.6 ±13.3 years). At baseline, SLE-DAS remission (score ≤2.08), mild (2.08–7.64) and moderate/high disease activity (>7.64) was present in 364(71.3%), 75(14.7%) and 71(13.9%) patients, respectively. SLE-DAS index-based remission (score ≤2.08 and prednisone ≤5 mg/day) was achieved in 337(66.1%) patients. SLE-DAS correlated significantly with SLEDAI-2K and PGA (rho 0.92 and 0.62, respectively; p<0.01 in both). Patients with SLE-DAS index-based remission reported a significantly higher LupusPRO health-related (HR) QoL score compared to those without (76.8 ±16.2 vs. 69.0 ±16.8; p<0.01). A total of 139 patients with PGA ≥0.5 at baseline were reassessed at month 6: 77(55.4%) patients had improvement in SLE-DAS and 61(43.9%) patients achieved SLE-DAS index-based remission. The change in SLE-DAS was significantly associated with an improvement in LupusPRO HRQoL score (rho -0.30; p<0.01).
CONCLUSIONS:
SLE-DAS remission was associated with better QoL in patients with SLE. Reduction in SLE-DAS over time correlates significantly with improvement in health-related QoL.

DOI: https://doi.org/10.55563/clinexprheumatol/1n8j8d

Rheumatology Article