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Prevalence of remission and its effect on damage and quality of life in Chinese patients with systemic lupus erythematosus
  1. Chi Chiu Mok,
  2. Ling Yin Ho,
  3. Sau Mei Tse,
  4. Kar Li Chan
  1. Department of Medicine, Tuen Mun Hospital, Hong Kong, China
  1. Correspondence to Dr Chi Chiu Mok, Department of Medicine, Tuen Mun Hospital, Tsing Chung Koon Road, New Territories, Hong Kong, SAR China; ccmok2005{at}yahoo.com

Abstract

Objectives To study the prevalence of remission and its effect on damage and quality of life (QOL) in Chinese patients with systemic lupus erythematosus (SLE).

Methods Patients who fulfilled ≥4 American College of Rheumatology criteria for SLE were identified. Their remission status at last clinic visits was determined by the European consensus criteria (complete/clinical remission ± immunosuppressive drugs). The increase in SLE damage index (SDI) in the preceding 5 years was compared between patients who were and were not in remission for ≥5 years. QOL of patients as assessed by the validated Chinese version of the Medical Outcomes Study Short-Form-36 (SF36) and the LupusPRO was also compared between the remission and non-remission groups by statistical analysis.

Results 769 SLE patients were studied (92% women; age: 46.4±14.6 years; SLE duration: 12.6±8.1 years). At last visit, clinical remission was present in 259 (33.7%) patients and complete remission was present in 280 (36.4%) patients. Clinical and complete remissions for ≥5 years were achieved in 64 (8.3%) and 129 (16.8%) of the patients, respectively. Patients remitted for ≥5 years were older, and had significantly lower prevalence of renal involvement, leucopenia or thrombocytopaenia. Fifty-three (6.9%) patients in remission ≥5 years were taken off all medications, including hydroxychloroquine (HCQ) (drug-free). Patients who remitted for ≥5 years but off-therapy (except HCQ) had significantly less SDI increment than those who did not remit (0.17±0.53 vs 0.67±1.10; p<0.001). Among 453 patients who had QOL assessment, remission for ≥5 years was associated with significantly higher SF36 and the total health-related scores of the LupusPRO.

Conclusions Durable remission can be achieved in a quarter of patients with SLE. Patients with remission for ≥5 years have significantly less damage accrual and better QOL. Prolonged remission is an appropriate criterion for outcome assessment in SLE.

  • remission
  • damage
  • quality of life
  • lupus
  • Chinese

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Footnotes

  • Contributor CCM: design, data collection and interpretation, and statistical analyses; LYH: data collection and interpretation; SMT: data collection and interpretation; KLC: data collection and interpretation.

  • Competing interests None declared.

  • Ethics approval Ethics Committee of Tuen Mun Hospital, HK.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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