Sex-Based Evaluation of Systemic Lupus Erythematosus and Quality of Life

The health and quality of life (QoL) of people living with systemic lupus erythematosus (SLE) vary by age and sex, especially in the reproductive age groups, according to study results published in Arthritis Care & Research.

To evaluate the QoL of men and women with SLE, the study included patients who met the American College of Rheumatology classification criteria for SLE and were enrolled in The Study of Outcomes in Lupus repository. The Lupus Patient-Reported Outcome (LupusPRO) tool was used to assess disease-specific health-related and non-health-related QoL (non-HRQoL) in both sexes; nonparametric tests were used to compare QoL with disease activity. A total of 1803 patients with SLE (mean age, 40.8±13.1 years) of different racial backgrounds participated in the study; 6.7% (122) were men and 93.3% (1681) were women.

Results showed that while there were no differences between men and women in mean age, ethnicity, and disease activity, damage scores were higher in men. The LupusPRO non-HRQoL construct showed that men exhibited significantly lower social support median scores (62.5) compared with women (75.0). But, in terms of HRQoL, women vs men showed worse scores in some domains, including lupus symptoms (75.0 vs 83.3), cognition (62.5 vs 75.0), physical health (85.0 vs 90.0), and pain-vitality (65.0 vs 75.0). Between age-matched men and women with SLE in the reproductive age group (≤45 years), it was again observed that men reported greater damage scores (P < .001). Overall, disease damage was higher in men than women, especially in the reproductive age group.

According to the investigators, the study has clinical relevance as it addresses concerns in the QoL of men and women of reproductive age with SLE. But the study had some limitations including the small sample size of men (n=122), incomplete information about disease activity and damage from patients, and the inconsistence in the number of participants of the various ethnicities (40% Asian, 14% Hispanic, 8% black, etc), which could have affected the generalizability of the results.

In conclusion, the study investigators said, “A focused evaluation and discussion of effects of SLE on patient QoL should also include sex-specific QoL concerns, and these should be considered when developing patient management plans.”

Disclosures

This research was supported by Cornell Brewer Foundation and the NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases’ Intramural Research Program. Dr Torralba received fees from Pfizer, Exagen, and GlaxoSmithKline, and LupusPRO is the copyrighted property of Rush University, Chicago, Illinois.

Reference

Jolly M, Sequeira W, Block JA, et al. Sex differences in quality of life in patients with systemic lupus erythematosus [published online April 25, 2018]. Arthritis Care Res. doi:10.1002/acr.23588