Severe, but not mild-moderate, flares are associated with a poorer health-related quality of life (HRQOL) in patients with systemic lupus erythematosus (SLE), according to study results published in Lupus Science & Medicine.

Patients with SLE have an impaired HRQOL; however, the impact of disease activity and damage on HRQOL is still unclear.

In a retrospective analysis, researchers sought to evaluate the association between flare severity and HRQOL in patients with SLE.


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Individuals who were enrolled in the Almenara Lupus Cohort in Lima, Peru, with at least 2 outpatient visits between December 2015 and February 2020 were included in the study.

Flare was defined as an increase of at least 4 points in the SLE Disease Activity Index 2000 (SLEDAI-2K) between visits. Flares were categorized based on the final SLEDAI-2K score as severe (12 or higher) or mild-moderate (less than 12). The LupusQoL questionnaire was used to assess HRQOL among patients.

Univariate and multivariate analyses were performed for each domain of the LupusQoL, adjusting for potential confounders.

Of a total of 277 patients included in the study, 256 (92.4%) were women. Patients had a mean age at diagnosis of 36.0±13.3 years; disease duration of 9.0±7.0 years; and follow-up of 2.7±1.1 years. Flares were identified in 115 of 1098 visits, including 17 severe and 98 mild-moderate flares.

After adjusting for possible confounders, severe flares were significantly associated with poorer HRQOL in planning, pain, emotional health, and fatigue domains on the LupusQoL. There was no association between mild-moderate flares and HRQOL.

Study limitations included the possible impact of disease characteristics on HRQOL prior to the baseline visit, the small sample size, and low prevalence of some comorbidities that could have affected the HRQOL.

The researchers concluded, “This study reinforces the need to develop effective strategies that allow us to prevent flares.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

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