Background: Patient (pt)-reported outcome measures (PROMs) provide information on a pt’s own perception of disease impact, helping to provide a global perspective of disease when combined with conventional physician assessments. There is a discrepancy in PROMs between pts with rheumatoid arthritis (RA) and those with systemic lupus erythematosus (SLE); improvements in PROMs are often seen within the first year after diagnosis among pts with RA,¹ but not SLE.² Whether this discrepancy persists during subsequent years is unknown.

Objectives: To compare changes in PROMs among pts with SLE versus RA within the first 60 months after diagnosis.

Methods: Pts with SLE with no prior organ damage were consecutively enrolled (2010–2015) from the Clinical Lupus Register in Northeastern Gothia and met the ≥4 of the 1982 American College of Rheumatology (ACR) and/or the 2012 Systemic Lupus International Collaborating Clinics classification criteria. Pts with RA were included from the observational 2nd Management of Early Intervention in RA cohort (TIRA-2; 2006–2009),³ which enrolled pts with recent-onset RA; 84% of patients fulfilled the 1987 ACR criteria. Pts in both cohorts had symptoms for <12 months prior to diagnosis/inclusion and were treated according to Swedish guidelines. Pts with SLE or RA were followed prospectively after diagnosis. PROMs (quality of life: EuroQoL-5 Dimensions [EQ-5D]; activity limitations: Health Assessment Questionnaire [HAQ]; pain, fatigue, and well-being: Visual Analogue Scale 0–100 mm) were collected at Months 0 (inclusion), 6, 12, 24, 36, 48, and 60. HAQ, pain, fatigue, well-being: higher scores indicate greater severity; EQ-5D: lower scores indicate greater severity.

Results: 41 pts with SLE and 522 pts with RA were included in this analysis. Numerical differences between cohorts in age, sex, and tobacco smoking were seen (Table). Baseline PROM scores were generally worse for pts with RA versus SLE (Figs 1 and 2). However, an improvement in PROM scores was seen by Month 6 for pts with RA, but not SLE. Between Months 6 and 60, PROM scores remained largely unchanged for both groups.

Conclusion: PROMs in pts with early SLE tended to remain stable in the years following diagnosis compared with the improvement experienced by pts with early RA, indicating a greater unmet need in SLE. The lack of improvement in PROMs in pts with SLE may be due to the disease’s impact across multiple organ systems, which may take longer to resolve versus RA symptoms. These results imply there is room for improvement in disease management – both pharmacological and multi-professional interventions. Data should be interpreted with caution due a low number of pts with SLE.

References: [1]Versteeg GA et al. Clin Rheumatol. 2018;37:1189-1197.

[2]Heijke R et al. Arthritis Rheumatol. 2018;70 (suppl 10):abstract 2633.

[3]Hallert E et al. Scand J Rheumatol. 2015;44:100-105.

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Acknowledgments: Sreeram Ramagopalan (supervised analysis). Lola Parfitt (medical writing, Caudex; funding: BMS)

Disclosure of Interests: Mathilda Bjork: None declared, Ingrid Thyberg: None declared, Alf Kastbom Consultant of: Bristol-Myers Squibb, Pfizer, Roche, UCB, Employee of: Sanofi, Speakers bureau: Bristol-Myers Squibb, UCB, Rebecca Heijke: None declared, Laura McDonald Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Evo Alemao Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Christopher Sjowall: None declared