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Holistic approaches in systemic lupus erythematosus: do physicians avoid addressing difficult-to-treat but highly relevant symptoms?
Örebro University, School of Medical Sciences. Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, and Center for Molecular Medicine (CMM), Stockholm, Sweden; Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-4875-5395
Department of Clinical and Academic Rheumatology, King's College Hospital, London, UK.
Division of Rheumatology, Toronto Lupus Program, University Health Network, Schroeder Arthritis Institute, University of Toronto, Toronto, Ontario, Canada.
Lupus Europe, Brussels, Belgium.
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2025 (English)In: RMD Open, E-ISSN 2056-5933, Vol. 11, no 1, article id e005400Article, review/survey (Refereed) Published
Abstract [en]

Despite advancements in the management of systemic lupus erythematosus (SLE), patients experience poor health-related quality of life (hrQoL) and premature death due to disease severity and treatment side effects. Achieving remission offers substantial benefits, including improved hrQoL and reduced mortality, yet the complexity of SLE, with its diverse underlying immune mechanisms and clinical manifestations, hampers progress. Involvement of the central nervous system with symptoms like fatigue, pain and brain fog often goes unaddressed due to limited evidence-based guidance and measurement tools. This neglect reflects gaps in training, discomfort in addressing untreatable symptoms and an overemphasis on evidence-based medicine, compromising holistic care. Recognising patient-reported outcomes has shifted SLE care towards a more patient-centred model, addressing hrQoL and aligning treatment goals. Embracing this approach and prioritising symptom management, even when a definitive cure is lacking, ensures compassionate, comprehensive care that improves adherence, satisfaction and the overall lived experience of patients with SLE.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2025. Vol. 11, no 1, article id e005400
Keywords [en]
Health-Related Quality Of Life, Lupus Erythematosus, Systemic, Patient Reported Outcome Measures, Treatment
National Category
Immunology
Identifiers
URN: urn:nbn:se:oru:diva-119785DOI: 10.1136/rmdopen-2024-005400ISI: 001440552300001PubMedID: 40055003Scopus ID: 2-s2.0-105000000145OAI: oai:DiVA.org:oru-119785DiVA, id: diva2:1943179
Funder
Swedish Rheumatism Association, R-995882Stiftelsen Konung Gustaf V:s 80-årsfond, FAI-2023-1055Swedish Society of Medicine, SLS-974449Nyckelfonden, OLL-1000881Stiftelsen Ulla och Roland Gustafssons Donationsfond, 2024-43Region Stockholm, FoUI-1004114Karolinska InstituteSwedish Rheumatism Association, R-993724Stiftelsen Konung Gustaf V:s 80-årsfond, FAI-2022-0877Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse, 2022Stiftelsen Ulla och Roland Gustafssons Donationsfond, 2023-36Region Östergötland, RÖ-981263
Note

Funding Agencies:

IP is supported by grants from the Swedish Rheumatism Association (R-995882), King Gustaf V’s 80-year Foundation (FAI-2023-1055), Swedish Society of Medicine (SLS-974449), Nyckelfonden (OLL-1000881), Professor Nanna Svartz Foundation (2021-00436), Ulla and Roland Gustafsson Foundation (2024-43), Region Stockholm (FoUI-1004114), and Karolinska Institutet. CS is supported by grants from the Swedish Rheumatism Association (R-993724), Swedish Research Council for Medicine and Health (2023-02256), King Gustaf V’s 80-year Foundation (FAI-2022-0877), King Gustaf V and Queen Victoria’s Freemasons’ Foundation (2022), Ulla and Roland Gustafsson Foundation (2023-36), and Region Östergötland ALF (RÖ-981263).

Available from: 2025-03-10 Created: 2025-03-10 Last updated: 2026-01-23Bibliographically approved

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