Background Health-related quality of life (HRQoL) represents patient's overall perception of the illness, symptoms severity and treatment impact on physical, emotional and social functions, and became an important complementary source of information in patients with Systemic Lupus Erythematosus (SLE). Older age, disease duration and higher scores of activity and damage seems to have an impact on the reduction of HRQoL, but according to many scientific researches, this data is still controversial.
Objectives to determine the HRQoL and its relationship to clinical and demographic data in patients with SLE.
Methods We consecutively included 30 SLE patients. Quality of life was evaluated using the Medical Outcomes Survey Short Form-36 (SF-36, version 2). Disease activity was measured using Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus Activity Measure (SLAM); organ damage assessed by the Systemic Lupus International Coordinating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI). Relationships between QoL domains and other characteristics were measured using Spearman's correlation coefficients.
Results All patients in the study group were women, 86.7% Asians and 23.3% Caucasians with mean age of 32.67 years (95% CI 28.26; 37.07) and mean duration disease of 6.87 years (95% CI 4.11;9.63). Renal and central nervous system involvement occurred in most patients with SLE (60% and 53.3% respectively), and there was a high incidence of mucocutaneous (66.7%) and musculo-skeletal disorders (arthralgia – 66.7%; arthritis 26.7%), that probably affected the reduction of QoL. Mean SDI was 1.03 with damage in 53.3%. Age and disease duration did not show any significant relationship with the HRQOL scores in any of the domains. Similarly, there were no statistically significant correlations between the scores of the SF-36 domains and scores of SLEDAI and SLICC/ACR-DI indexes. However, higher disease activity scores measured by SLAM showed significant inverse correlation with lower bodily pain (BP) scale score (rs=0.525, p=0.003) and physical component summary score (rs=0.583, p=0.001). Reductions in the BP scale of the SF-36 were comparable with high values of visual analog pain scale. The fact that only SLAM index had correlation with QoL could be explained by higher degree of disease activity in patients assessed by SLAM compared to assessed by SLEDAI index (twenty three patients (76.7%) had high and very high activity by the SLAM index, but only nineteen patients (63.4%) had the same level of disease activity by the SLEDAI). Probably, possible reasons were using only the objective parameters by SLEDAI index and the assessment period, as SLAM scale evaluates activity of the disease during four weeks, whereas SLEDAI scale - during last ten days.
Conclusions From obtained results we concluded that there is no clinically important associations between the all domains of the SF-36 and age, disease duration and accumulated damage. Probably, chronic pain, physical functional limitations significantly reduce the quality of life in patients with high disease activity. However, low level of mental component summary and other scales scores of SF-36 could not be explained by the disease activity. This suggests that HRQoL remain an important independent outcome measures in the assessment of full impact of the disease on patient's functioning and should be recommended for evaluation in SLE patients.
Disclosure of Interest None declared