1
|
Adaptation and validation of the Bulgarian version of the Systemic Lupus Erythematosus Quality of Life Questionnaire (L-QoL). Clin Rheumatol 2023:10.1007/s10067-023-06523-w. [PMID: 36913029 DOI: 10.1007/s10067-023-06523-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE Systemic lupus erythematosus (SLE) is a heterogeneous disease with multiple clinical manifestations, which causes a significant deterioration in the quality of life (QoL). The Systemic Lupus Erythematosus Quality of Life Questionnaire (L-QoL) is a lupus-specific measure used to determine the burden of the disease and it applies the need-based model of QoL. Our aim was to produce the first successfully validated foreign language version of the questionnaire. METHODS The development of the Bulgarian version involved three stages: translation, field testing and psychometric evaluation. Translation was conducted by an expert linguist working with a developer of the original L-QoL, followed by interviews with monolingual lay individuals. Face and content validity of the translation were assessed by cognitive debriefing interviews with Bulgarian SLE patients. Finally, the L-QoL was validated by administering the questionnaire to a random sample of SLE patients on two occasions, 2 weeks apart to evaluate its reliability and validity. RESULTS In the validation survey, the new Bulgarian version demonstrated high internal consistency (the Cronbach's alpha coefficient was 0.92), and test-retest reliability (0.97). Additionally, scores on the L-QoL were correlated with those on the SF-36 sections to determine convergent validity and the strongest correlation was observed between L-QoL scores and the social functioning section of the SF-36. Known group validity was established by testing the ability of the Bulgarian L-QoL to distinguish between subgroups of patients from the study pool. CONCLUSIONS The demonstrated excellent psychometric properties ensure that the Bulgarian L-QoL accurately captures the impact of SLE on the quality of life. Key points • The Bulgarian version of the L-QoL is a valid and reliable measure of QoL in lupus patients. • The Bulgarian version of the L-QoL can be used as an outcome measure in research, clinical trials and routine clinical practice.
Collapse
|
2
|
Stull D, O’Quinn S, Williams B, Bean S, Schwetje E, Abreu G, Tummala R. Causal cascade of direct and indirect effects of anifrolumab on patient-reported outcomes: structural equation modelling of two Phase 3 trials. Rheumatology (Oxford) 2022; 61:4731-4740. [PMID: 35274691 PMCID: PMC9707104 DOI: 10.1093/rheumatology/keac138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 02/25/2022] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES SLE significantly impairs health-related quality of life (HRQoL). In this post hoc analysis, structural equation modelling was used to examine the 'causal cascade' of interaction between anifrolumab, disease activity and patient-reported outcomes (PROs) in pooled data from the phase 3 TULIP-1 and TULIP-2 trials. METHODS Data were pooled from the TULIP-1 (n = 364) and TULIP-2 (n = 362) randomized, placebo-controlled, 52-week trials of intravenous anifrolumab (300 mg every 4 weeks for 48 weeks). We evaluated changes from baseline to week 24 and week 52 in four clinical (BICLA, BILAG-2004, SLEDAI-2K and changes in glucocorticoid dosage) and six PRO measures (SF-36, FACIT-F, EQ-5D, LupusQoL, PHQ-8 and pain NRS) in our hypothesized model of interactions. RESULTS Our hypothesized model had an acceptable fit to the pooled TULIP trial data. At week 24, significant paths revealed that when compared with placebo, anifrolumab treatment improved disease activity as measured by BICLA, BILAG-2004, SLEDAI-2K and changes to glucocorticoid dosage. In turn, these clinical measures reduced pain, which improved fatigue, physical functioning, mood/emotions and HRQoL. When the model incorporated number of glucocorticoid tapers as the measure of change in glucocorticoid dosage, treatment effects of anifrolumab on glucocorticoid tapers were not retained at week 52. However, at week 52 treatment indirectly improved HRQoL through its direct effects on BICLA. CONCLUSIONS Anifrolumab is associated with significant patient-reported improvements in aspects of HRQoL including pain, fatigue, mood and physical function. These benefits are from the direct effect of anifrolumab treatment on disease activity and reduction in glucocorticoid dosage.
Collapse
Affiliation(s)
- Donald Stull
- Patient Centered Endpoints, IQVIA, New York City, NY
| | | | | | | | - Erik Schwetje
- BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Gabriel Abreu
- BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Raj Tummala
- Correspondence to: Raj Tummala, Global Clinical Head, Anifrolumab, BioPharmaceuticals R&D, 1 MedImmune Way, Gaithersburg, MD 20878, USA. E-mail:
| |
Collapse
|
3
|
Sayadi L, Faezi ST, Hasanpour M, Alahmadi SJ. The Relationship of Lifestyle with Disease Activity among Patients with Systemic Lupus Erythematosus: A Descriptive-Correlational Study. Mediterr J Rheumatol 2021; 32:124-133. [PMID: 34447908 PMCID: PMC8369272 DOI: 10.31138/mjr.32.2.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/05/2020] [Accepted: 12/15/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: The objective of this study was to evaluate the relationship of lifestyle with disease activity among patients with systemic lupus erythematosus. Methods: This cross-sectional descriptive-correlational study was conducted in 2019 on 209 patients with systemic lupus erythematosus. Data were collected using a demographic and clinical characteristics questionnaire, the Health-Promoting Lifestyle Profile II, and the systemic lupus erythematosus disease activity Index. The data were analysed through the mixed model and the logistic regression analyses. Results: In total, 67.5% of participants had active disease. The mean score of lifestyle was 2.49±0.30 and the lowest and the highest lifestyle dimensional mean scores were respectively related to the physical activity and the health responsibility dimensions (1.55±0.60 and 3.25±0.45). The analysis showed that each one point increase in the mean score of lifestyle was associated with 0.79 point decrease in the odds of disease activity (P = 0.006). Moreover, disease activity had significant positive relationship with body mass index (P = 0.015). Conclusion: Interventions for promoting lifestyle among these patients and improving healthcare providers’ knowledge about Systemic lupus erythematosus and lifestyle modification are recommended to reduce disease activity.
Collapse
Affiliation(s)
- Leila Sayadi
- Nursing and Midwifery Care Research Centre, School of Nursing & Midwifery,Tehran University of Medical Sciences, Tehran, Iran
| | | | - Marzieh Hasanpour
- School of Nursing & Midwifery,Tehran University of Medical Sciences, Tehran, Iran
| | - Sofia Jami Alahmadi
- School of Nursing & Midwifery,Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
4
|
Nguyen MH, Huang FF, O’Neill SG. Patient-Reported Outcomes for Quality of Life in SLE: Essential in Clinical Trials and Ready for Routine Care. J Clin Med 2021; 10:jcm10163754. [PMID: 34442047 PMCID: PMC8396817 DOI: 10.3390/jcm10163754] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/17/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022] Open
Abstract
Patient-reported outcome (PRO) instruments are widely used to assess quality of life in Systemic Lupus Erythematosus (SLE) research, and there is growing evidence for their use in clinical care. In this review, we evaluate the current evidence for their use in assessing quality of life in SLE in both research and clinical settings and examine the different characteristics of the commonly used PRO tools. There are now several well-validated generic and SLE-specific tools that have demonstrated utility in clinical trials and several tools that complement activity and damage measures in the clinical setting. PRO tools may help overcome physician–patient discordance in SLE and are valuable in the assessment of fibromyalgia and type 2 symptoms such as widespread pain and fatigue. Future work will identify optimal PRO tools for different settings but, despite current limitations, they are ready to be incorporated into patient care.
Collapse
Affiliation(s)
- Matthew H. Nguyen
- Liverpool Hospital, Liverpool, NSW 2170, Australia;
- Pathology Department, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia
| | - Frank F. Huang
- Rheumatology Department, Royal North Shore Hospital, St Leonards, NSW 2065, Australia;
| | - Sean G. O’Neill
- Rheumatology Department, Royal North Shore Hospital, St Leonards, NSW 2065, Australia;
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW 2065, Australia
- Correspondence: ; Tel.: +61-02-94631890
| |
Collapse
|
5
|
Elnady B, Taha A, Desouky DE, Abd-Elmakoud SF, Rageh EM, Algethami AM, Algethami M, ten Klooster PM, Rasker JJ. Impact of sustained remission on quality of life among women with rheumatoid arthritis and systemic lupus erythematosus: a prospective observational study. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2021. [DOI: 10.1186/s43166-021-00072-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Abstract
Background
Health-related quality of life (HRQOL) as a patient reported outcome plays important roles in the life of patients with RA (rheumatoid arthritis) and SLE (Systemic lupus erythematosus) as well as their families. Evaluating the impact of sustained remission on HRQOL is important and could be of potential help in daily practice. Thus, we aimed to assess and compare prospectively the impact of sustained remission on HRQOL in Saudi RA and SLE female cohorts.
Results
Sixty-two female patients with active RA and 34 female patients with active SLE fulfilled the inclusion-, entry- and follow-up criteria. At baseline, the SLE patients had significantly better SF-36 scores than the RA patients. In both groups, significant correlations were found between disease activity and physical (PCS) and mental (MCS) components summary of the SF-36 (all p’s ≤ 0.001). In sustained remission, both SLE and RA patients showed significant improvements of the SF-36 scores (p < 0.001) compared to baseline. RA patients in sustained remission had a significantly better general health, bodily pain and physical functioning, and total PCS scores (p < 0.001) than those with SLE.
Conclusions
Both SLE and RA patients in sustained remission showed strongly improved HRQOL. In sustained remission, RA patients had comparable or better HRQOL than SLE patients.
Collapse
|
6
|
Manzano BR, da Silva Santos PS, Bariquelo MH, Merlini NRG, Honório HM, Rubira CMF. A case-control study of oral diseases and quality of life in individuals with rheumatoid arthritis and systemic lupus erythematosus. Clin Oral Investig 2020; 25:2081-2092. [PMID: 32803443 DOI: 10.1007/s00784-020-03518-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 08/10/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To evaluate the impact of oral alterations on the quality of life (QoL) of individuals with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). METHODS A case-control study in 32 individuals with RA, 28 with SLE, and 29 in the control group (CG). The questionnaire SF-36 (Medical Outcomes Study Short-Form 36) was used to evaluate the health-related quality of life (HRQoL), and OHIP-14 (Oral Health Impact Profile-14) was used to evaluate the oral health-related quality of life (OHRQoL). The severity of xerostomia was evaluated by the Xerostomia Inventory (XI). In the clinical examination, decayed (D-T), missing(M-T), and filled teeth (F-T) (DMF-T), periodontal status, plaque index (PI), gingival index (GI), unstimulated whole salivary flow rate (UWSFR), and stimulated whole salivary flow rate (SWSFR) were also assessed. Data were analyzed by Student's t tests, chi-square test, Kruskal-Wallis test, ANOVA, Pearson's correlation, and Spearman's correlation. RESULTS Individuals with RA had a higher caries index (D-T/p = 0.004) and more frequent periodontal disease (PI/p = 0.017). In the SLE group, there was a significant lower salivary flow (SFR/p = 0.016, SFMS/p = 0.004) and severe xerostomia (p = 0.002). The impact of ORHQoL in individuals with RA occurred due to oral candidiasis, halitosis, and xerostomia, compromising the HRQoL. Overall, OHRQoL and HRQoL were more compromised in individuals with SLE, with xerostomia being the main oral problem. CONCLUSION Individuals with RA and SLE present oral diseases with negative impact on their QoL. CLINICAL RELEVANCE This study shows the main oral manifestations in rheumatic autoimmune diseases, with mainly xerostomia compromising the quality of life.
Collapse
Affiliation(s)
- Brena Rodrigues Manzano
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Alameda Dr Octávio Pinheiro Brisolla, 9-75, Bauru, 17012-901, Brazil.
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Alameda Dr Octávio Pinheiro Brisolla, 9-75, Bauru, 17012-901, Brazil
| | - Matheus Henrique Bariquelo
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Silvio Marchione, 3-20, Bauru, 17012-900, Brazil
| | | | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr Octávio Pinheiro Brisolla, 9-75, Bauru, 17012-901, Brazil
| | - Cássia Maria Fischer Rubira
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Alameda Dr Octávio Pinheiro Brisolla, 9-75, Bauru, 17012-901, Brazil
| |
Collapse
|
7
|
Ra JH, Leung J, Baker EA, Kim AHJ. Patient Perspective on Using Digital Resources to Address Unmet Needs in Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken) 2020; 73:1568-1576. [PMID: 32741146 DOI: 10.1002/acr.24399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/21/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The clinical variability of systemic lupus erythematosus (SLE) caused by the unpredictability of flares contributes to patients experiencing a diminished sense of social support. Digital health interventions (DHIs) have the potential to improve patients' social support but have yet to be studied extensively in SLE. Our objective was to assess general and SLE-specific internet usage as well as specific suggestions for SLE-related digital resources and tools among patients with SLE at the Washington University Lupus Clinic. METHODS Fifty-six participants were recruited from the Washington University Lupus Clinic. Ten-minute structured interviews consisting of multiple choice and open-ended questions were conducted. A descriptive statistical analysis was conducted with the quantitative data, while the qualitative data were analyzed using an open coding approach. RESULTS Nearly all respondents indicated having access to the internet (98.2%). Eighty percent currently use the internet for their SLE. The qualitative data indicate that patients with SLE use the internet for understanding flares and changes in their symptoms and/or laboratory results, want an increased variety of SLE information online, have a desire to exchange personal experiences and knowledge of SLE with others, and desire increased diversity in the methods of delivering digital SLE information. CONCLUSION Our findings support the continued use of DHIs for patients with SLE. We believe that these findings will aid the future development of DHIs tailored to patients with SLE.
Collapse
Affiliation(s)
- Jennifer H Ra
- Washington University School of Medicine, St. Louis, Missouri
| | | | | | - Alfred H J Kim
- Washington University School of Medicine, St. Louis, Missouri
| |
Collapse
|
8
|
Health-Related Quality of Life in Antiphospholipid Syndrome: Current Knowledge and Future Perspectives. Curr Rheumatol Rep 2020; 22:20. [PMID: 32405870 DOI: 10.1007/s11926-020-00900-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE OF REVIEW Antiphospholipid syndrome (APS) is a chronic autoimmune disease that can be seen as a burden, with consequences on patients' daily life. Health has traditionally been measured using measures of morbidity or mortality. Health-related quality of life (HRQoL) is a concept that includes quality of life through physical, mental, and social domains. As in other autoimmune diseases, HRQoL has been investigated in patients with APS. Here, we provide a comprehensive review of the current knowledge of the assessment of HRQoL in APS. RECENT FINDINGS APS patients have an impaired HRQoL compared with the general population. The presence of systemic lupus erythematosus (SLE) in APS patients is associated with a worse HRQoL than in patients without SLE. Several determinants of HRQoL impairment in APS have been identified: age, gender, history of arterial thrombosis, organ damage, lack of social support and treatments. This review highlights the negative impact of thrombosis on APS patients' HRQoL that should not be neglected. Besides, there is a need for a better strategy of communication and information, in order to improve HRQoL in APS.
Collapse
|
9
|
Parodis I, Lopez Benavides AH, Zickert A, Pettersson S, Möller S, Welin Henriksson E, Voss A, Gunnarsson I. The Impact of Belimumab and Rituximab on Health-Related Quality of Life in Patients With Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken) 2020; 71:811-821. [PMID: 30055091 DOI: 10.1002/acr.23718] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 07/24/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Accumulating evidence supports an impaired health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE). We investigated the effects of 2 biologic treatments on HRQoL of patients with SLE. METHODS Patients with SLE from the Karolinska University Hospital treated with belimumab (n = 34) or rituximab (n = 35) were included; normative values derived from Swedish population-based controls matched for age and sex were used for the purpose of comparisons. Data were collected prospectively at treatment initiation and at months 3, 6, 12, and 24, using the Short Form 36 (SF-36) health questionnaire, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) scale, the EuroQol 5-dimension (EQ-5D) instrument, and the Stanford Health Assessment Questionnaire disability index (HAQ DI). RESULTS Substantial decrements from Swedish norms were observed across all SF-36 domains at baseline. Patients treated with belimumab reported gradual improvements in the SF-36 physical component summary (significant from month 12; P = 0.023) and FACIT-Fatigue (significant by month 24; P = 0.001), no changes in EQ-5D scores, and improvements in HAQ DI by month 6 (P = 0.014). Patients treated with rituximab showed rapid improvements in the SF-36 mental component summary and FACIT-Fatigue by month 3 (P = 0.031 and P = 0.007, respectively), as well as improvements in EQ-5D at month 6 (P = 0.016) and HAQ DI at month 3 (P = 0.033). Based on baseline evaluations, patients receiving antimalarial agents (n = 33) performed better in the SF-36 social functioning (P = 0.022) and mental health (P = 0.023) domains compared to patients who did not receive antimalarial agents (n = 36). CONCLUSION Our results corroborated previous findings of considerable HRQoL impairments in patients with SLE. Patients' perceptions of HRQoL showed discrepant patterns over time in the 2 treatment groups and could provide additional information along with the clinical evaluation of biologic therapy in SLE. Further survey on the effects of antimalarial agents on the HRQoL of patients with SLE in larger cohorts is merited.
Collapse
Affiliation(s)
- Ioannis Parodis
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Angie H Lopez Benavides
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden, and Odense University Hospital, Odense, Denmark
| | - Agneta Zickert
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Susanne Pettersson
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Sonia Möller
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | | | - Anne Voss
- Odense University Hospital, Odense, Denmark
| | - Iva Gunnarsson
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
10
|
Sumner LA, Olmstead R, Azizoddin DR, Ormseth SR, Draper TL, Ayeroff JR, Zamora-Racaza G, Weisman MH, Nicassio PM. The contributions of socioeconomic status, perceived stress, and depression to disability in adults with systemic lupus erythematosus. Disabil Rehabil 2019; 42:1264-1269. [PMID: 30776317 DOI: 10.1080/09638288.2018.1522550] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Purpose: Psychological and sociodemographic factors contribute to disability in systemic lupus erythematosus. Yet the pathways by which these factors influence disability remain unclear. The objective of this study was to evaluate a model examining socioeconomic status (SES), perceived stress, and depressive symptoms as determinants of lupus-related disability.Methods: The sample included 134 patients receiving treatment at an academic hospital. Structural equation modeling examined the direct and indirect effects of SES (income, education, and subjective social status), perceived stress (Perceived Stress Scale), and depressive symptoms (Hospital Depression Anxiety Scale depression subscale) on disability (Lupus Patient-Reported Outcome measure Physical Health and Pain-Vitality subscales).Results: Structural equation modeling confirmed that the model fit the data well. The SES exerted a direct negative effect on perceived stress (β = -0.40, p < 0.001). In turn, perceived stress predicted higher levels of depression (β = 0.72, p < 0.001), which ultimately contributed to greater disability (β = 0.53, p < 0.001). The influence of SES on disability was indirect (mediated by perceived stress and depression).Conclusions: Findings support the socioeconomic gradient in disability as mediated by perceived stress and depression, such that lower SES contributed to lupus-related disability via perceived stress and depressive symptoms.Implications for RehabilitationLow socioeconomic status, perceived stress, and depression are prognostic factors for the disability in systemic lupus erythematosus.Study findings indicate that perceived stress and depression fully mediate (account for) the negative impact of low socioeconomic status on lupus-related disability.Screening for and addressing psychological distress may enhance management of disability in lupus patients.This research demonstrates the value of a conceptual framework for identifying potentially modifiable risk factors for disability in lupus and other chronic disabling diseases.
Collapse
Affiliation(s)
- Lekeisha A Sumner
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Richard Olmstead
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Sarah R Ormseth
- Division of Rheumatology, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - Taylor L Draper
- Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Julia R Ayeroff
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Psychology, Loma Linda University, Loma Linda, CA, USA
| | - Geraldine Zamora-Racaza
- Post-baccalaureate Premedical Program, University of Southern California, Los Angeles, CA, USA
| | - Michael H Weisman
- Department of Medicine, University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Perry M Nicassio
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
11
|
Behiry ME, Ahmed SA, Elsebaie EH. Assessment of Quality of Life (QoL) in Systemic Lupus Erythematosus Patients at a Tertiary Care Hospital in Egypt. Curr Rheumatol Rev 2019; 15:304-311. [PMID: 30657042 DOI: 10.2174/1573397115666190118144903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 10/31/2018] [Accepted: 01/02/2019] [Indexed: 11/22/2022]
Abstract
Systemic Lupus Erythematosus (SLE) has a profound impact on quality of life. OBJECTIVE The objective of this study was to explore the quality of life among Egyptian SLE patients and to assess its relationships with demographic and clinical features. METHODS One hundred sixty-four SLE patients were recruited for this study. Demographic information; clinical parameters; disease activity, as evaluated by the systemic lupus erythematosus Disease Activity Index; and organ damage, as assessed by the systemic lupus international Collaborative Clinics/American College of Rheumatology Damage Index, were reported. Quality of life was assessed with a quality of life questionnaire specifically designed for patients with systemic lupus erythematosus; the questions are grouped in the following six domains: physical function, sociooccupational activities, symptoms, treatment, mood, and self-image. Higher values indicate poorer quality of life. RESULTS Of the 164 Egyptian SLE patients who completed the survey, 142 (86.6%) were women. The mean age of the participants was 31± 8 years, the mean systemic lupus erythematosus disease activity index score was 17 ± 11, the mean systemic lupus international collaborative clinics/ American College of Rheumatology Damage Index score was 0.9 ± 1.2, and the mean quality of life score was 18.23± 6.89. Strong correlations were found between the total quality of life score and the scores for each domain of the questionnaire separately and disease activity, neurological manifestations, renal manifestations and musculoskeletal manifestations (p<0.0001); moreover, there was a significant positive correlation between the Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index score and the total quality of life score (p=0.005). CONCLUSION Poor quality of life among Egyptian SLE patients and disease activity are strongly related to impaired lifestyles in these patients.
Collapse
Affiliation(s)
- Mervat E Behiry
- Lecturer of Rheumatology and Immunology Unit at Internal Medicine Cairo University, Cairo, Egypt
| | - Sahar A Ahmed
- Lecturer of Rheumatology and Immunology Unit at Internal Medicine Cairo University, Cairo, Egypt
| | - Eman H Elsebaie
- Lecturer of Public Health and Community Medicine Cairo University, Cairo, Egypt
| |
Collapse
|
12
|
Elera-Fitzcarrald C, Fuentes A, González LA, Burgos PI, Alarcón GS, Ugarte-Gil MF. Factors affecting quality of life in patients with systemic lupus erythematosus: important considerations and potential interventions. Expert Rev Clin Immunol 2018; 14:915-931. [DOI: 10.1080/1744666x.2018.1529566] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Claudia Elera-Fitzcarrald
- Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Perú
- Universidad Científica del Sur, Lima, Perú
| | - Alejandro Fuentes
- Departamento de Inmunología Clínica y Reumatología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis Alonso González
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Paula I. Burgos
- Departamento de Inmunología Clínica y Reumatología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Graciela S. Alarcón
- The University of Alabama at Birmingham, Birmingham, AL, USA
- Division of Clinical Immunology and Rheumatology, Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Manuel F. Ugarte-Gil
- Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Perú
- Universidad Científica del Sur, Lima, Perú
| |
Collapse
|
13
|
Moon SJ, Kang KY, Kwok SK, Ju JH, Hong YS, Park SH, Jeon CH, Choi ST, Song JS, Min JK. Differences in quality of life determinants according to the presence of fibromyalgia in middle-aged female patients with systemic lupus erythematosus: a multicenter, cross-sectional, single-ethnicity cohort. Int J Rheum Dis 2018; 21:1173-1184. [DOI: 10.1111/1756-185x.13320] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Su-Jin Moon
- Division of Rheumatology; Department of Internal Medicine; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - Kwi Young Kang
- Division of Rheumatology; Department of Internal Medicine; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - Seung-Ki Kwok
- Division of Rheumatology; Department of Internal Medicine; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - Ji Hyeon Ju
- Division of Rheumatology; Department of Internal Medicine; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - Yeon-Sik Hong
- Division of Rheumatology; Department of Internal Medicine; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - Sung-Hwan Park
- Division of Rheumatology; Department of Internal Medicine; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - Chan Hong Jeon
- Division of Rheumatology; Department of Internal Medicine; Soonchunhyang University Bucheon Hospital; Bucheon Korea
| | - Sang Tae Choi
- Division of Rheumatology; Department of Internal Medicine; Chung-Ang University College of Medicine; Seoul Korea
| | - Jung-Soo Song
- Division of Rheumatology; Department of Internal Medicine; Chung-Ang University College of Medicine; Seoul Korea
| | - Jun-Ki Min
- Division of Rheumatology; Department of Internal Medicine; College of Medicine; The Catholic University of Korea; Seoul Korea
| |
Collapse
|
14
|
Annapureddy N, Giangreco D, Devilliers H, Block JA, Jolly M. Psychometric properties of MDHAQ/RAPID3 in patients with systemic lupus erythematosus. Lupus 2018; 27:982-990. [DOI: 10.1177/0961203318758503] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- N Annapureddy
- Division of Rheumatology and Immunology, Vanderbilt University, Nashville, TN, USA
| | - D Giangreco
- Division of Rheumatology, Department of Medicine, Rush University Medical Center, Chicago, IL, USA
| | - H Devilliers
- Internal Medicine and Systemic Disease Unit, Dijon University Hospital, Dijon, France
| | - J A Block
- Division of Rheumatology, Department of Medicine, Rush University Medical Center, Chicago, IL, USA
| | - M Jolly
- Division of Rheumatology, Department of Medicine, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
15
|
Carnero Contentti E, Genco ND, Hryb JP, Caspi M, Chiganer E, Di Pace JL, López PA, Lessa C, Caride A, Perassolo M. Impact of multiple sclerosis on quality of life: Comparison with systemic lupus erythematosus. Clin Neurol Neurosurg 2017; 163:149-155. [DOI: 10.1016/j.clineuro.2017.10.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 08/23/2017] [Accepted: 10/28/2017] [Indexed: 11/27/2022]
|
16
|
Annapureddy N, Devilliers H, Jolly M. Patient-reported outcomes in lupus clinical trials with biologics. Lupus 2017; 25:1111-21. [PMID: 27497256 DOI: 10.1177/0961203316652494] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Therapeutic advances in systemic lupus erythematosus (SLE) are greatly needed. Despite advances in our knowledge of pathogenesis of the disease and targets, treatment remains a significant challenge. Finding effective and relatively safe medications remains one of the top priorities. SLE significantly impairs quality of life (QoL), and patient-reported outcomes (PROs) measure a unique aspect of the disease not captured by disease activity. Inclusion of PRO measurements is encouraged in SLE clinical trials, as they allow capturing benefits of a proposed intervention in language patients can relate to and in areas deemed pertinent and important to and by patients. Availability of patient-reported and patient-centric clinical trials data may facilitate patients in informed and shared decision making, and allow for comparative cost-effectiveness evaluation for future resource allocation and reimbursements. Herein we review clinical trials with biologic therapies wherein PRO tools were included in the study design.
Collapse
Affiliation(s)
| | - H Devilliers
- Internal Medicine and Systemic Disease Unit, Dijon University Hospital, Dijon, France
| | - M Jolly
- Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
17
|
Choi MY, Barber MRW, Barber CEH, Clarke AE, Fritzler MJ. Preventing the development of SLE: identifying risk factors and proposing pathways for clinical care. Lupus 2017; 25:838-49. [PMID: 27252260 DOI: 10.1177/0961203316640367] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Although challenging, developing evidence-based approaches to an early and accurate diagnosis of systemic lupus erythematosus is a key approach to preventing disease and lupus-associated morbidity and mortality. Advances in our understanding of preclinical and incomplete lupus erythematosus have enabled the identification of risk factors that may predict disease and the development of potential strategies aimed at primary prevention. Emerging data support the notion that there is a temporal disease progression from initial asymptomatic autoimmunity (preclinical lupus) through early clinical features of the disease (incomplete lupus erythematosus) to finally becoming fully classifiable systemic lupus erythematosus (complete lupus erythematosus). Here, we review the demographic, clinical, biomarker as well as genetic and environmental features that are reported to increase the risk of disease progression. Based on these risk factors, we propose a clinical care pathway for patients with early disease. We envisage that such a pathway, through early identification of disease, may improve patient outcomes, while reducing health care costs.
Collapse
Affiliation(s)
- M Y Choi
- University of Calgary, Cumming School of Medicine, Calgary, Canada
| | - M R W Barber
- University of Calgary, Cumming School of Medicine, Calgary, Canada
| | - C E H Barber
- University of Calgary, Cumming School of Medicine, Calgary, Canada
| | - A E Clarke
- University of Calgary, Cumming School of Medicine, Calgary, Canada
| | - M J Fritzler
- University of Calgary, Cumming School of Medicine, Calgary, Canada
| |
Collapse
|
18
|
Chaigne B, Finckh A, Alpizar-Rodriguez D, Courvoisier D, Ribi C, Chizzolini C. Differential impact of systemic lupus erythematosus and rheumatoid arthritis on health-related quality of life. Qual Life Res 2017; 26:1767-1775. [DOI: 10.1007/s11136-017-1534-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 01/24/2023]
|
19
|
Factors Associated with Health-Related Quality of Life in Mexican Lupus Patients Using the LupusQol. PLoS One 2017; 12:e0170209. [PMID: 28114336 PMCID: PMC5256863 DOI: 10.1371/journal.pone.0170209] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 01/02/2017] [Indexed: 01/10/2023] Open
Abstract
Introduction Health-related quality of life (HRQOL) is affected by numerous clinical variables, including disease activity, damage, fibromyalgia, depression and anxiety. However, these associations have not yet been described in Mexican patients with systemic lupus erythematosus (SLE). Objective To evaluate the relationship between disease activity, damage, depression and fibromyalgia and HRQOL measured by the LupusQoL-instrument in Mexican patients with SLE. Methods A cross-sectional study was conducted in women fulfilling the 1997 ACR classification criteria for SLE. HRQOL was evaluated using a disease-specific instrument for SLE, the LupusQoL (validated for the Spanish-speaking population). Patients were evaluated clinically to determine the degree of disease activity and damage using the Mexican Systemic Lupus Erythematosus Disease Activity Index (Mex-SLEDAI) and Systemic Lupus International Collaborating Clinics-Damage Index (SLICC), respectively. Fibromyalgia and depression were assessed using the ACR criteria and the CES-D scale, respectively. The relationship between HRQOL and these variables was measured using Spearman’s rank correlation coefficient and linear regression analysis. Results A total of 138 women with SLE, age 40.3±11 years, disease duration 8.8±6.4 years, with disease activity in 51.4%, depression in 50%, damage in 43% and fibromyalgia in 19.6% were included. Poorer HRQOL correlated with depression (r = -0.61; p< 0.005), fibromyalgia (r = -0.42; p< 0.005), disease activity (r = -0.37; p < 0.005) and damage (r = -0.31; p < 0.005). In the multivariate linear regression analysis, damage (β = -3.756, p<0.005), fibromyalgia (β = -0.920, p<0.005), depression (β = -0.911, p<0.005) and disease activity (β = -0.911, p<0.005) were associated with poor HRQOL. Conclusion SLE disease activity, damage, fibromyalgia and depression were associated with poor HRQOL in our sample of Mexican SLE patients.
Collapse
|
20
|
Calderón J, Flores P, Aguirre JM, Valdivia G, Padilla O, Barra I, Scoriels L, Herrera S, González A, Massardo L. Impact of cognitive impairment, depression, disease activity, and disease damage on quality of life in women with systemic lupus erythematosus. Scand J Rheumatol 2016; 46:273-280. [PMID: 27701937 DOI: 10.1080/03009742.2016.1206617] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To define the relative role of cognitive impairment, depression, disease activity, and disease damage in the decreased health-related quality of life (HRQoL) frequently observed in systemic lupus erythematosus (SLE) patients. METHOD We studied 101 Chilean female SLE patients and applied the 12-item Medical Outcomes Study (MOS) Short Form Health Survey version 2 (SF-12v2) to assess HRQoL and the Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess cognitive function. Analysis of covariance (ANCOVA) models included demographic and disease-related factors and cognitive function tests of sustained attention, memory, and executive function. RESULTS All measures of HRQoL were lower in the 101 female SLE patients compared to the women from the Chilean general population. HRQoL was associated with the following factors: (i) depression symptoms, which were detrimental to all components of the physical and mental HRQoL scores; (ii) executive dysfunction (spatial planning), which was associated with lower scores on role limitations due to physical health problems and emotional problems, and general health perceptions; (iii) higher activity and organ damage were deleterious to role physical, bodily pain, and physical summary scores; and (iv) higher damage also impacted physical function. Impairments in sustained attention and memory did not decrease the HRQoL. CONCLUSIONS Our results highlight the relevance of executive dysfunction to poor physical and mental health components of HRQoL in SLE together with depression, while disease activity and disease damage are associated with lower HRQoL physical components. The need for cognitive function evaluation and rehabilitation in SLE is indicated.
Collapse
Affiliation(s)
- J Calderón
- a Department of Psychiatry, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - P Flores
- a Department of Psychiatry, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - J M Aguirre
- a Department of Psychiatry, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - G Valdivia
- b Department of Public Health, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - O Padilla
- b Department of Public Health, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - I Barra
- c School of Medicine, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - L Scoriels
- d Institute of Biomedical Sciences , Federal University of Rio de Janeiro , Rio de Janeiro , Brazil
| | - S Herrera
- c School of Medicine, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - A González
- e Department of Clinical Immunology and Rheumatology, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile.,f Centre for Ageing and Regeneration (CARE), Department of Molecular and Cell Biology, Faculty of Biological Sciences , Pontifical Catholic University of Chile , Santiago , Chile
| | - L Massardo
- e Department of Clinical Immunology and Rheumatology, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| |
Collapse
|
21
|
Mazzoni D, Cicognani E, Prati G. Health-related quality of life in systemic lupus erythematosus: a longitudinal study on the impact of problematic support and self-efficacy. Lupus 2016; 26:125-131. [DOI: 10.1177/0961203316646459] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objectives: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease which can affect any organ in the body, reducing patients' health-related quality of life (HR-QOL). Psychosocial research on SLE is quite recent and is mostly based on qualitative and cross-sectional evidence. Some studies suggest that a protective role is played by perceived self-efficacy in the management of the disease, while a detrimental role is played by problematic social interactions. Methods: In a longitudinal study, we tested the independent contribution of self-efficacy and problematic social support, in predicting patients' HR-QOL after 11 months. An online questionnaire was completed by 162 participants with SLE, the second questionnaire after 11 months. Results: Controlling for corticosteroids and hydroxychloroquine use, self-efficacy in the management of the disease at Time 1 showed a significant and positive effect on HR-QOL at Time 2, while problematic social support (denying/uninformed) showed a negative effect. Conclusions: HR-QOL of SLE patients is influenced by self-efficacy in the management of the disease and problematic support. Specific attention should be paid to the quality of patients' social relationships and their perceived efficacy in the management of the disease in focused interventions as in daily clinical practice.
Collapse
Affiliation(s)
- D Mazzoni
- Department of Psychology, University of Bologna, Italy
| | - E Cicognani
- Department of Psychology, University of Bologna, Italy
| | - G Prati
- Department of Psychology, University of Bologna, Italy
| |
Collapse
|
22
|
Carter EE, Barr SG, Clarke AE. The global burden of SLE: prevalence, health disparities and socioeconomic impact. Nat Rev Rheumatol 2016; 12:605-20. [PMID: 27558659 DOI: 10.1038/nrrheum.2016.137] [Citation(s) in RCA: 273] [Impact Index Per Article: 34.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can potentially lead to serious organ complications and even death. Its global burden - in terms of incidence and prevalence, differential impact on populations, economic costs and capacity to compromise health-related quality of life - remains incompletely understood. The reported worldwide incidence and prevalence of SLE vary considerably; this variation is probably attributable to a variety of factors, including ethnic and geographic differences in the populations being studied, the definition of SLE applied, and the methods of case identification. Despite the heterogeneous nature of the disease, distinct patterns of disease presentation, severity and course can often be related to differences in ethnicity, income level, education, health insurance status, level of social support and medication compliance, as well as environmental and occupational factors. Given the potential for the disease to cause such severe and widespread organ damage, not only are the attendant direct costs high, but these costs are sometimes exceeded by indirect costs owing to loss of economic productivity. As an intangible cost, patients with SLE are, not surprisingly, likely to endure considerably reduced health-related quality of life.
Collapse
Affiliation(s)
- Erin E Carter
- University of Calgary, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Road S.W., Calgary, Alberta T2T 5C7, Canada
| | - Susan G Barr
- University of Calgary, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Road S.W., Calgary, Alberta T2T 5C7, Canada
| | - Ann E Clarke
- University of Calgary, Health Research Innovation Centre, 3280 Hospital Drive N.W., Calgary, Alberta T2N 4N1, Canada
| |
Collapse
|
23
|
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect many organs, including the skin, joints, the central nervous system and the kidneys. Women of childbearing age and certain racial groups are typically predisposed to developing the condition. Rare, inherited, single-gene complement deficiencies are strongly associated with SLE, but the disease is inherited in a polygenic manner in most patients. Genetic interactions with environmental factors, particularly UV light exposure, Epstein-Barr virus infection and hormonal factors, might initiate the disease, resulting in immune dysregulation at the level of cytokines, T cells, B cells and macrophages. Diagnosis is primarily clinical and remains challenging because of the heterogeneity of SLE. Classification criteria have aided clinical trials, but, despite this, only one drug (that is, belimumab) has been approved for use in SLE in the past 60 years. The 10-year mortality has improved and toxic adverse effects of older medications such as cyclophosphamide and glucocorticoids have been partially offset by newer drugs such as mycophenolate mofetil and glucocorticoid-sparing regimes. However, further improvements have been hampered by the adverse effects of renal and neuropsychiatric involvement and late diagnosis. Adding to this burden is the increased risk of premature cardiovascular disease in SLE together with the risk of infection made worse by immunosuppressive therapy. Challenges remain with treatment-resistant disease and symptoms such as fatigue. Newer therapies may bring hope of better outcomes, and the refinement to stem cell and genetic techniques might offer a cure in the future.
Collapse
|
24
|
Jolly M, Galicier L, Aumaître O, Francès C, Le Guern V, Lioté F, Smail A, Limal N, Perard L, Desmurs-Clavel H, Boutin DLTH, Asli B, Kahn JE, Pourrat J, Sailler L, Ackermann F, Papo T, Sacré K, Fain O, Stirnemann J, Cacoub P, Jallouli M, Leroux G, Cohen-Bittan J, Hulot JS, Arora S, Amoura Z, Piette JC, Costedoat-Chalumeau N. Quality of life in systemic lupus erythematosus: description in a cohort of French patients and association with blood hydroxychloroquine levels. Lupus 2016; 25:735-740. [DOI: 10.1177/0961203315627200] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Objectives Benefits of hydroxychloroquine (HCQ) use on physician reported outcomes are well documented in systemic lupus erythematosus (SLE). We assess for the first time the association and predictive value of blood HCQ levels towards health-related quality of life (HRQOL) in SLE. Methods Data from the PLUS study (a randomized, double-blind, placebo-controlled, multicentre study) were utilized. Blood HCQ levels were quantified by high-performance liquid chromatography along with HRQOL assessments (Medical Outcomes Study-SF-36) at baseline (V1) and month 7 (V2). Results 166 SLE patients’ data were analysed. Mean (SD) age and disease duration were 44.4 (10.7) and 9.3 (6.8) years. Eighty-seven per cent were women. Mean (SD, median, IQR) HCQ concentrations in the blood at V1 were 660 (314, 615, 424) ng/ml and increased to 1020 (632, 906, 781) ng/ml at V2 (mean difference 366 units, 95% confidence interval −472 to −260, p < 0.001). No significant correlations between HCQ concentrations with HRQOL domains at V1 or V2 were noted. There were no differences in HRQOL stratified by HCQ concentrations. HCQ concentrations at V1 or changes in HCQ concentration (V2-V1) were not predictive of HRQOL at V2 or changes in HRQOL (V2-V1). Conclusions No association of HCQ concentrations with current or longitudinal HRQOL were found in SLE.
Collapse
Affiliation(s)
- M Jolly
- Rush University Medical Center, Chicago, IL, USA
| | - L Galicier
- Université Paris Diderot, Sorbonne Paris-Cité and AP-HP, Hôpital Saint Louis, service d’immunologie clinique, Paris, France
| | - O Aumaître
- Université de Clermont-Ferrand and CHU Clermont-Ferrand, Hôpital Gabriel Montpied, service de médecine interne, Clermont-Ferrand, France
| | - C Francès
- UPMC, Université Paris 6 and AP-HP, Hôpital Tenon, service de dermatologie allergologie, Paris, France
| | - V Le Guern
- Université Paris-Decartes and AP-HP, Hôpital Cochin, service de médecine interne, Paris, France
| | - F Lioté
- Université Paris-Diderot, Sorbonne Paris-Cité and AP-HP, Hôpital Lariboisière, service de rhumatologie, Paris, France
| | - A Smail
- CHU Amiens, Hôpital Nord, service de médecine interne, Amiens, France
| | - N Limal
- UPEC; AP-HP, Hôpital Henri Mondor, service de médecine interne, Créteil, France
| | - L Perard
- Hospices Civils de Lyon, Groupement Hospitalier Edouard Herriot, service de médecine interne, Lyon, France
| | - H Desmurs-Clavel
- Hospices Civils de Lyon, Groupement Hospitalier Edouard Herriot, service de médecine interne, Lyon, France
| | - D L T H Boutin
- UPMC, Université Paris 6 and AP-HP, Hôpital Pitié-Salpêtrière, service de médecine interne, Paris, France
| | - B Asli
- Université Paris Diderot, Sorbonne Paris-Cité and AP-HP, Hôpital Saint Louis, service d’immunologie clinique, Paris, France
| | - J-E Kahn
- Hôpital Foch, service de médecine interne, Suresnes, France
| | - J Pourrat
- Université Paul-Sabatier and CHU Toulouse, Hôpital Rangueil, service de néphrologie, Toulouse, France
| | - L Sailler
- Université Paul-Sabatier and CHU Toulouse, Hôpital Purpan, service de médecine interne, Toulouse, France
| | - F Ackermann
- Hôpital Foch, service de médecine interne, Suresnes, France
| | - T Papo
- Université Paris-Diderot, Sorbonne Paris-Cité and AP-HP, Hôpital Bichat Claude-Bernard, service de médecine interne, Paris, France
| | - K Sacré
- Université Paris-Diderot, Sorbonne Paris-Cité and AP-HP, Hôpital Bichat Claude-Bernard, service de médecine interne, Paris, France
| | - O Fain
- Hôpital Saint Antoine, DHU i2B, service de médecine interne, Université Paris 6
| | - J Stirnemann
- Division of General Internal Medicine, Geneva University Hospital, Geneva, Switzerland
| | - P Cacoub
- APHP, Département de Médecine Interne et Immunologie clinique, Groupe Hospitalier Pitié Salpétriére Paris, France; DHU Inflammation, Immunopathologie, Biothérapie, Université Pierre et Marie Curie, Paris VI, France; UMR 7211 (UPMC/CNRS), UMR S-959 (INSERM)
| | - M Jallouli
- Université Paris-Decartes and AP-HP, Hôpital Cochin, service de médecine interne, Paris, France
| | - G Leroux
- UPMC, Université Paris 6 and AP-HP, Hôpital Pitié-Salpêtrière, service de médecine interne, Paris, France
| | - J Cohen-Bittan
- UPMC, Université Paris 6 and AP-HP, Hôpital Pitié-Salpêtrière, service de gériatrie Pr Verny, Paris, France
| | - J-S Hulot
- Sorbonne Universités, UPMC Univ Paris 06, AP-HP, Institute of Cardiometabolism and Nutrition (ICAN), F-75013, Paris, France
| | - S Arora
- Rush University Medical Center, Chicago, IL, USA
| | - Z Amoura
- UPMC, Université Paris 6 and AP-HP, Hôpital Pitié-Salpêtrière, service de médecine interne, Paris, France
| | - J-C Piette
- UPMC, Université Paris 6 and AP-HP, Hôpital Pitié-Salpêtrière, service de médecine interne, Paris, France
| | - N Costedoat-Chalumeau
- Université Paris-Decartes and AP-HP, Hôpital Cochin, service de médecine interne, Paris, France
| | | |
Collapse
|
25
|
Sabio JM. Lupus eritematoso sistémico a día de hoy. Med Clin (Barc) 2016; 146:160-2. [DOI: 10.1016/j.medcli.2015.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 08/06/2015] [Indexed: 10/23/2022]
|
26
|
Sabio JM. Systemic lupus erythematosus today. MEDICINA CLÍNICA (ENGLISH EDITION) 2016; 146:160-162. [DOI: 10.1016/j.medcle.2016.04.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
|
27
|
Mazzoni D, Cicognani E. Positive and problematic support, stress and quality of life in patients with systemic lupus erythematosus. ANXIETY STRESS AND COPING 2016; 29:542-51. [DOI: 10.1080/10615806.2015.1134785] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Davide Mazzoni
- Department of Psychology, University of Bologna, Bologna, Italy
| | | |
Collapse
|
28
|
van Tuyl LHD, Boers M. Patient-reported outcomes in core domain sets for rheumatic diseases. Nat Rev Rheumatol 2015; 11:705-12. [PMID: 26324860 DOI: 10.1038/nrrheum.2015.116] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Patient-reported outcomes (PROs) are abundant in rheumatology and their numbers continue to increase. But which of the available measures are most important? Core outcome sets-including groups of domains and instruments for measuring them-have been defined for many rheumatic diseases, with the aim that all these outcomes should be measured in every clinical trial. The subgroup of PROs included in these core sets is, therefore, undoubtedly important. This Review summarizes the PROs included in core outcome sets developed for use in clinical trials across a wide range of rheumatic diseases. Three PROs are commonly utilized across the majority of rheumatic conditions: pain, physical functioning and the patient global assessment of disease activity. However, additional research is needed to fully understand the role of the patient global assessment of disease activity, to distinguish specific domains within the broad concept of health-related quality of life, and to work towards consensus on the choice between generic and disease-specific instruments in various contexts.
Collapse
Affiliation(s)
- Lilian H D van Tuyl
- Amsterdam Rheumatology and Immunology Center, VU University Medical Centre, PO Box 7057, Amsterdam, 1007 MB, Netherlands
| | - Maarten Boers
- Amsterdam Rheumatology and Immunology Center, VU University Medical Centre, PO Box 7057, Amsterdam, 1007 MB, Netherlands.,Department of Clinical Epidemiology and Biostatistics, VU University Medical Center, PO Box 7057, Amsterdam, 1007 MB, Netherlands
| |
Collapse
|
29
|
Zou YF, Xu JH, Pan FM, Tao JH, Xu SQ, Xiao H, Liu S, Cai J, Lian L, Chen PL, Wang DG, Liu SX, Liang CM, Ye QL, Tian G, Wu M, Gu YY, Pan HF, Su H, Ye DQ. Glucocorticoid receptor genetic polymorphisms is associated with improvement of health-related quality of life in Chinese population with systemic lupus erythematosus. Clin Rheumatol 2015; 34:1537-44. [DOI: 10.1007/s10067-015-3027-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 06/15/2015] [Accepted: 07/17/2015] [Indexed: 01/09/2023]
|
30
|
Giangreco D, Devilliers H, Annapureddy N, Block JA, Jolly M. Lupus Impact Tracker is responsive to physician and patient assessed changes in systemic lupus erythematosus. Lupus 2015; 24:1486-91. [PMID: 26162686 DOI: 10.1177/0961203315593168] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 06/03/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the responsiveness of Lupus Impact Tracker (LIT) to changes in physician and patient disease activity assessments over time. METHODS Available longitudinal data from routine patient care visits on LIT, physician assessed disease activity (physician global assessment (PGA), SELENA-SLEDAI score, SELENA Flare Index (SFI)), and patient-reported changes in systemic lupus erythematosus (SLE) health status were analyzed. Significant, clinically important change (worsening or improvement) in physician disease activity assessment or patient-reported SLE health status were judged using the following criteria: change of 0.3 on PGA, 4 on SELENA-SLEDAI, change in SFI status over time, and change of 2 in either direction in patient-reported SLE health status. Mixed model regression analysis was used to compare changes in LIT using the above criteria. RESULTS There were 1184 observations with significant changes in physician disease activity or patient-reported measure for 182 patients' data across 1364 visits. Patients' mean (SD) age and SELENA-SLEDAI were 43.5 (13.2) years and 6.4 (7.3) respectively. LIT mean scores decreased by more than 3 with improvement in PGA (standardized response mean -0.26, p < 0.05), while it increased by more than 5 with worsening in SELENA-SLEDAI (standardized response mean 0.42, p = 0.01). Mean change in LIT of greater than ±3 was noted with change in SFI status (p < 0.05). Mean LIT score decreased by greater than 4 and increased by greater than 2 with patient-reported improvement and worsening in SLE health status respectively (p < 0.05). CONCLUSIONS LIT is responsive to physician-assessed and patient-assessed changes in disease status. A mean LIT change of 2-4 may represent a significant clinical change in LIT. It is an effective tool that may be used by patients and physicians in tracking disease impact in SLE patients.
Collapse
Affiliation(s)
- D Giangreco
- Division of Rheumatology, Rush University Medical Center, Chicago, USA
| | - H Devilliers
- Department of Internal Medicine and Systemic Diseases, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - N Annapureddy
- Division of Rheumatology and Immunology, Vanderbilt University, Nashville, USA
| | - J A Block
- Division of Rheumatology, Rush University Medical Center, Chicago, USA
| | - M Jolly
- Division of Rheumatology, Rush University Medical Center, Chicago, USA
| |
Collapse
|
31
|
Doutre MS. [The ins and outs of evaluating lupus progression]. Ann Dermatol Venereol 2014; 141:571-3. [PMID: 25288058 DOI: 10.1016/j.annder.2014.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- M-S Doutre
- Service de dermatologie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33600 Pessac, France.
| |
Collapse
|
32
|
Wang SL, Wu B, Zhu LA, Leng L, Bucala R, Lu LJ. Construct and criterion validity of the Euro Qol-5D in patients with systemic lupus erythematosus. PLoS One 2014; 9:e98883. [PMID: 24892282 PMCID: PMC4043925 DOI: 10.1371/journal.pone.0098883] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 05/08/2014] [Indexed: 11/19/2022] Open
Abstract
Objective To investigate the construct and criterion validity of the Euro Qol-5D (EQ-5D), which allows quality-adjusted life-years to be calculated, in patients with systemic lupus erythematosus (SLE). Methods Consecutive SLE patients who had been followed at the Renji Hospital, School of Medicine, Shanghai Jiao Tong University were recruited. Cross-sectional correlations of the EQ-5D with equivalent domains in disease-specific health-related quality of life (HRQoL), LupusQol, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) measures, the Systemic Lupus International Collaborating Clinics Damage Index (SDI), and patient characteristics were tested. Discriminant validity to assess the ability to distinguish between patients of different disease severity was assessed. There also were evaluations of ceiling and floor effects. Results 240 patients were recruited in total. The EQ-5D correlated moderately to strongly with all domains of the LupusQoL (r: 0.44–0.7) apart from intimate relationships (r = 0.25) and body image (r = 0.18). There was moderate negative correlation between EQ-5D and clinical assessment of disease, SLEDAI (r = −0.589) and SDI (r = −0.509). When compared with equivalent domains on LupusQoL, there was good construct validity in EQ-5D (r: 0.631–0.812). EQ-5D could also discriminate patients with varied disease severity (according SLEDAI and SDI). There was no floor effect in EQ-5D but the ceiling effect remains strong (34%). Conclusion Our results provide sufficient evidence that the EQ-5D displays construct and criterion validity for use in SLE patients. Disease-specific measures of HRQoL used alongside may be a better choice.
Collapse
Affiliation(s)
- Su-li Wang
- Department of Rheumatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bin Wu
- Clinical Outcomes and Economics Group, Department of pharmacy, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li-an Zhu
- Department of Medicine, Section of Rheumatology, Yale University School of Medicine, The Anlyan Center, New Haven, Connecticut, United States of America
| | - Lin Leng
- Department of Medicine, Section of Rheumatology, Yale University School of Medicine, The Anlyan Center, New Haven, Connecticut, United States of America
| | - Richard Bucala
- Department of Medicine, Section of Rheumatology, Yale University School of Medicine, The Anlyan Center, New Haven, Connecticut, United States of America
| | - Liang-jing Lu
- Department of Rheumatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- * E-mail:
| |
Collapse
|
33
|
van Vollenhoven RF, Mosca M, Bertsias G, Isenberg D, Kuhn A, Lerstrøm K, Aringer M, Bootsma H, Boumpas D, Bruce IN, Cervera R, Clarke A, Costedoat-Chalumeau N, Czirják L, Derksen R, Dörner T, Gordon C, Graninger W, Houssiau F, Inanc M, Jacobsen S, Jayne D, Jedryka-Goral A, Levitsky A, Levy R, Mariette X, Morand E, Navarra S, Neumann I, Rahman A, Rovenský J, Smolen J, Vasconcelos C, Voskuyl A, Voss A, Zakharova H, Zoma A, Schneider M. Treat-to-target in systemic lupus erythematosus: recommendations from an international task force. Ann Rheum Dis 2014; 73:958-67. [DOI: 10.1136/annrheumdis-2013-205139] [Citation(s) in RCA: 446] [Impact Index Per Article: 44.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
34
|
Touma Z, Urowitz MB, Gladman DD. Outcome measures in systemic lupus erythematosus. INDIAN JOURNAL OF RHEUMATOLOGY 2013. [DOI: 10.1016/j.injr.2013.11.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|