Background Various generic quality-of-life QoL (QoL) scales such as MOS 36-Item Short-Form Health Survey (SF-36) and disease-specific ones such as systemic lupus erythematosus QoL (SLEQOL) have been used to study the QoL of lupus patients. Most of the studies are cross-sectional and, consequently, information about the responsiveness of such instruments is scant.
Objectives We studied the responsiveness of SLEQOL and SF-36 in lupus patient as they receive new drug treatment.
Methods We selected patients from our prospective SLE registry who were prescribed new medications. We studied the differences in the QoL at study visits just before and just after the introduction of azathioprine, oral cyclophosphamide, intravenous cyclophosphamide, danazol, cyclosporine A, mycophenolate or hydroxychloroquine in an intention-to-treat manner. We collected clinical data and scores from SF-36, SLEQOL, Rheumatology Attitudes Index (RAI), SLE Disease Activity Index (SLEDAI) and revised Systemic Lupus Activity Measure (SLAM-R).
Results There were 216 SLE patients (with 194 females) with 303 new drug initiations. The mean age was 36.23 ± 11.78 years. The mean age of diagnosis was 27.65 ± 10.34 years. Using SLEQOL, we found that the use of IV cyclophosphamide, mycophenolate and azathioprine is associated with significant improvements in QoL, in contrast to oral cyclophosphamide, cyclosporin A, danazol and hydroxychloroquine. IV cyclophosphamide is associated with improvement in the physical functioning, activities and self-image domains of SLEQOL, mycophenolate in the treatment and self-image domains and azathioprine in the activities and mood domains. SF-36 reflected QoL change with the use of IV cyclophosphamide (general health domain) and mycophenolate (physical functioning and role physical).
Conclusions SLEQOL is responsive to the changes in QoL of SLE patients as they receive new medications. It distinguishes the differential effects on QoL of the various drugs. Different domains of the SLEQOL and SF-36 improved with the various medications. SLEQOL may be useful as an outcome measure in SLE clinical trials.
Disclosure of Interest None Declared
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