Associations of SLE-QoL, SF-36 and patient's global rating change (GRC) with lupus low disease activity state (LLDAS): A longitudinal study.

Abstract

Objective: To examine the associations of patient reported out-comes (PROs) with LLDAS. Method(s): SLE patients attending a rheumatology clinic in Thailand between 2013 and 2017 completed specific (SLE-QoL) and generic (SF36) health-related quality of life (HR-QoL) surveys, and rated their global change (GRC) in QoL compared to their previous visit using a 7-point Likert scale. Patients' changes in QoL were categorised as 'no change' (-1 to +1), 'deterioration' (-2 to-7) or 'improvement' (+2, to +7). LLDAS was defined as described (Franklyn K, et al. Ann Rheum Dis 16; 75: 1615). Associations of PROs (SLE-QoL, SF36 and GRC) with LLDAS were examined using generalised estimating equations. Result(s): 337 patients (2062 visits) were included in the study. Patients' median age [inter-quartile range (IQR)] and study duration were 37 [28, 48] years and 1162 [567, 1246] days, respectively. 81% of patients achieved LLDAS at least once during the study period. SLE-QoL and SF36 survey components were significantly correlated (P < 0.01). Patients who were in LLDAS had statistically significantly higher scores in both SLE-QoL and SF36 surveys when compared to patients who were not. Patients reported improvement in 58%, deterioration in 15% and no change in QoL in 27% of all visits. Compared to the no change group, QoL deterioration was significantly associated with reduced odds of subsequently achieving LLDAS (OR 0.53, 95%CI: 0.39-0.72, P < 0.001), but QoL improvement was not associated with increased odds of achieving LLDAS. Conclusion(s): LLDAS is associated with improved HR-QoL, and improving QoL predicts LLDAS attainment.