Lupus Severity Negatively Impacts Patients’ Quality of Life, Research Shows

New research from Switzerland reported that disease activity in patients with systemic lupus erythematosus (SLE) has a negative impact on the quality of life of these patients.

The study, titled “Impact of disease activity on health-related quality of life in systemic lupus erythematosus — a cross-sectional analysis of the Swiss Systemic Lupus Erythematosus Cohort Study (SSCS),” was recently published in the journal BMC Immunology.

SLE is an autoimmune disease with a diverse array of symptoms that can adversely affect the joint, skin, kidney, neurologic and hematologic systems. Chronic fatigue and pain are also common in patients with SLE.

To assess the impact of disease activity on health-related quality of life (HRQoL), the researchers analyzed 252 patients diagnosed with SLE. Data was collected on patients included in the Swiss SLE Cohort Study (SSCS) between April 2007 and June 2014. All patients were aged 18 or older, and were diagnosed with SLE according to current ACR classification criteria.

Patients were asked to fill out a questionnaire designed to assess HRQOL — the generic Medical Outcomes Study 36-Item Short Form Health Survey (SF36). Disease activity was compared against SF36 scores to better understand how disease severity affects quality of life.

Disease activity was determined using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score with the Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA modification). Patients were placed into two groups based on their SELENA-SLEDAI score: inactive vs. active disease. Disease activity was also assessed using the Physician’s Global Assessment (PGA) score.

The researchers found that disease activity had a negative influence on all dimensions of HRQoL. Elevated erythrocyte sedimentation rate (ESR), a marker of inflammation, was also found to be negatively correlated with SF36 scores.

Patients with active lupus nephritis (kidney inflammation) and musculoskeletal involvement were particularly likely to have low scores and were more likely to suffer from physical limitations, increased pain, and emotional problems.

“In conclusion, our study confirms a low HRQoL in a large cohort of Swiss SLE patients,” the researchers wrote. “Disease activity assessed by SELENA-SLEDAI, PGA, and ESR all negatively correlate with most HRQoL outcomes. HRQoL was decreased in those with active musculoskeletal and renal involvement and in the presence of classical markers of biological activity.”

The team noted, however, that addititonal studies are needed to assess chronicity of SLE and quality of life over a longer period of time.