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

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.