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Changes in quality of life in the first 5 years of disease in a multicenter cohort of patients with systemic lupus erythematosus.
Urowitz, M; Gladman, D D; IbaƱez, D; Sanchez-Guerrero, J; Bae, S C; Gordon, C; Fortin, P R; Clarke, A; Bernatsky, S; Hanly, J G; Wallace, D J; Isenberg, D; Rahman, A; Merrill, J; Ginzler, E; AlarcĆ³n, G S; Fessler, B; Khamashta, M; Steinsson, K; Petri, M; Dooley, M; Bruce, I N; Manzi, S; Sturfelt, G; Nived, O; Ramsey-Goldman, R; Zoma, A; Maddison, P; Kalunian, K; van Vollenhoven, R; Aranow, C; Romero Diaz, J; Stoll, T
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Arthritis care & research
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66
Publication Issue
9
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1374
Publication End
9
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Abstract
The Medical Outcomes Study Short Form 36 (SF-36) is recommended to assess quality of life (QOL) in systemic lupus erythematosus (SLE). The aim of the current study was to assess QOL over time in the first 5 years of a multicenter inception cohort of patients with SLE.
An inception SLE cohort was assembled according to a standardized protocol between 2000 and 2012. In addition to clinical and laboratory assessments, patients completed the SF-36 at yearly intervals. Only patients who had ā„5 completed QOL questionnaires were included in these analyses. Generalized estimating equation models were run separately for each of the 8 subscales and for the physical and mental component summary scores, adjusting for repeated measures by patients.
A total of 495 patients were included. The mean Ā± SD disease duration at the first visit was 5.3 Ā± 4.1 months. The mean Ā± SD age at enrollment was 35.8 Ā± 13.2 years. All 8 subscales and the 2 summary scores showed improvement in the first 2 years from enrollment. Between years 2 and 5, none of the subscales or summary scores showed any change. Minimum clinically important improvement was achieved by 35-56% of the patients and was influenced by demographic and disease factors.
Unlike late-stage lupus, where QOL is stable over time, in patients with early disease, all subscales improve in early followup up to 2 years. Therefore, the SF-36 may be a sensitive outcome measure in early disease in patients with SLE.
An inception SLE cohort was assembled according to a standardized protocol between 2000 and 2012. In addition to clinical and laboratory assessments, patients completed the SF-36 at yearly intervals. Only patients who had ā„5 completed QOL questionnaires were included in these analyses. Generalized estimating equation models were run separately for each of the 8 subscales and for the physical and mental component summary scores, adjusting for repeated measures by patients.
A total of 495 patients were included. The mean Ā± SD disease duration at the first visit was 5.3 Ā± 4.1 months. The mean Ā± SD age at enrollment was 35.8 Ā± 13.2 years. All 8 subscales and the 2 summary scores showed improvement in the first 2 years from enrollment. Between years 2 and 5, none of the subscales or summary scores showed any change. Minimum clinically important improvement was achieved by 35-56% of the patients and was influenced by demographic and disease factors.
Unlike late-stage lupus, where QOL is stable over time, in patients with early disease, all subscales improve in early followup up to 2 years. Therefore, the SF-36 may be a sensitive outcome measure in early disease in patients with SLE.
Citation
Urowitz M, Gladman DD, IbaƱez D, Sanchez-Guerrero J, Bae SC, Gordon C, Fortin PR, Clarke A, Bernatsky S, Hanly JG, Wallace DJ, Isenberg D, Rahman A, Merrill J, Ginzler E, AlarcĆ³n GS, Fessler B, Khamashta M, Steinsson K, Petri M, Dooley M, Bruce IN, Manzi S, Sturfelt G, Nived O, Ramsey-Goldman R, Zoma A, Maddison P, Kalunian K, van Vollenhoven R, Aranow C, Romero Diaz J, Stoll T. Changes in quality of life in the first 5 years of disease in a multicenter cohort of patients with systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2014 Sep;66(9):1374-9. doi: 10.1002/acr.22299. PMID: 24497416.