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Impact of remission and low disease activity on health-related quality of life in patients with systemic lupus erythematosus
Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Departments of Medicine and Rheumatology, The University of Melbourne at St Vincent's Hospital, Fitzroy, Victoria, Australia.
Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
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2022 (English)In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, Vol. 61, no 12, p. 4752-4762Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To investigate the impact of remission and lupus low disease activity state (LLDAS) on health-related quality of life (HRQoL) in systemic lupus erythematosus.

METHODS: SF-36, EQ-5D-3L and FACIT-Fatigue data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials were used. Duration in remission/LLDAS required to reach a HRQoL benefit ≥ minimal clinically important differences (MCIDs) during and post-treatment was determined using quantile regression and generalised estimating equations.

RESULTS: Patients (N = 1684) were assessed every 4th week (15 visits). Four cumulative (β = 0.60) or four consecutive (β = 0.66) visits in remission were required to achieve a benefit ≥MCID in SF-36 physical component summary (PCS) scores, and six cumulative (β = 0.44) or five consecutive (β = 0.49) for a benefit ≥MCID in mental component summary (MCS) scores. Eight cumulative (β = 0.30 for both) or eight consecutive (β = 0.32 for both) visits in LLDAS were required for a benefit in PCS/MCS ≥MCID, respectively.For EQ-5D-3L index scores ≥MCID, six cumulative (β = 0.007) or five consecutive (β = 0.008) visits in remission were required, and eight cumulative (β = 0.005) or six consecutive (β = 0.006) visits in LLDAS. For FACIT-Fatigue scores ≥MCID, 12 cumulative (β = 0.34) or 10 consecutive (β = 0.39) visits in remission were required, and 17 cumulative (β = 0.24) or 16 consecutive (β = 0.25) visits in LLDAS.

CONCLUSION: Remission and LLDAS contribute to a HRQoL benefit in a time-dependent manner. Shorter time in remission than in LLDAS was required for a clinically important benefit in HRQoL, and longer time in remission for a benefit in mental compared with physical HRQoL aspects. When remission/LLDAS was sustained, the same benefit was achieved in a shorter time.

Place, publisher, year, edition, pages
Oxford University Press, 2022. Vol. 61, no 12, p. 4752-4762
Keywords [en]
health-related quality of life, lupus low disease activity state, remission, systemic lupus erythematosus, treat-to-target
National Category
Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:oru:diva-98155DOI: 10.1093/rheumatology/keac185ISI: 000787003500001PubMedID: 35302581Scopus ID: 2-s2.0-85137640548OAI: oai:DiVA.org:oru-98155DiVA, id: diva2:1645913
Funder
Swedish Rheumatism Association, R-941095King Gustaf V Jubilee Fund, FAI-2020-0741Region Stockholm, FoUI-955483The Karolinska Institutet's Research Foundation
Note

Funding agencies:

GlaxoSmithKline Investigator-Sponsored Studies (ISS) programme

Professor Nanna Svartz Foundation 2020-00368

Ulla and Roland Gustafsson Foundation 2021-26

Available from: 2022-03-21 Created: 2022-03-21 Last updated: 2023-12-08Bibliographically approved

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