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The impact of belimumab and rituximab on health-related quality of life in patients with systemic lupus erythematosus
Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Rheumatology, Karolinska University Hospital, Stockholm, Sweden.
Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Rheumatology, Karolinska University Hospital, Stockholm, Sweden; Department of Rheumatology, Odense University Hospital, Odense, Denmark.
Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Rheumatology, Karolinska University Hospital, Stockholm, Sweden.
Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Rheumatology, Karolinska University Hospital, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
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2019 (English)In: Arthritis care & research, ISSN 2151-464X, E-ISSN 2151-4658, Vol. 71, no 6, p. 811-821Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Accumulating evidence supports an impaired health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE). We investigated the effects of two biologic treatments on SLE patients' HRQoL.

METHODS: SLE patients from the Karolinska University Hospital treated with belimumab (n=34) or rituximab (n=35) were included; Swedish population-based age- and sex-matched norms served as controls. Data were collected prospectively at treatment initiation and at months 3, 6, 12 and 24; these included the SF-36, FACIT-Fatigue, EQ-5D, and Stanford HAQ-DI.

RESULTS: Substantial decrements from Swedish norms were observed across all SF-36 domains at baseline. Belimumab-treated patients 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). Rituximab-treated patients 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 were not (n=36).

CONCLUSION: Our findings corroborated considerable HRQoL impairments in SLE patients. Patients' perceptions of HRQoL showed discrepant patterns over time in the two treatment groups, and could provide additional information along with the clinical evaluation of biologic therapy in SLE. Survey on the effects of antimalarial agents on SLE patients' HRQoL in larger cohorts is merited.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019. Vol. 71, no 6, p. 811-821
Keywords [en]
Biologic agents, fatigue, health-related quality of life, systemic lupus erythematosus
National Category
Medical and Health Sciences Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:oru:diva-70525DOI: 10.1002/acr.23718PubMedID: 30055091Scopus ID: 2-s2.0-85064576980OAI: oai:DiVA.org:oru-70525DiVA, id: diva2:1298530
Available from: 2019-03-24 Created: 2019-03-24 Last updated: 2019-06-14Bibliographically approved

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Welin Henriksson, Elisabet

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