Impact of remission and low disease activity on health-related quality of life in patients with systemic lupus erythematosusShow others and affiliations
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
2022-03-212022-03-212023-12-08Bibliographically approved