THU0375 Quality of life in indian patients with systemic lupus erythematosus in durable remission: psychosocial and demographic factors
Authors: R.P. Goswami, R. Chatterjee, A. Mitra, B. Bhattacharya, A. Ghosh, P. Ghosh
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Remission in systemic lupus erythematosus (SLE) is uncommon. Detrimental effect of disease activity on quality of life (QoL) is reported but literature on QoL in lupus patients in durable remission is scant. <h3>Objectives</h3> To study QoL in Indian SLE patients in durable remission <h3>Methods</h3> We retrospectively included female SLE patients fulfilling ≥4 SLICC Classification Criteria, followed regularly at our clinic, who were in durable remission as determined by European consensus criteria (complete/clinical remission ±immunosuppressive drugs). QoL was assessed with Medical Outcomes Study Short-Form-12 (SF-12). We also collected data on demographics (age, duration of disease, years of education), duration and quality (complete versus clinical) of remission and patient reported fatigue through fatigue severity scale (FSS). A structured interview with a clinical psychologist using ICD-10 Diagnostic Criteria for Research (DCR) was performed to diagnose depression. Age matched female control subjects were also included and underwent similar exercises. Association of physical and mental component summary scores (PCS and MCS) of SF-12 with depression, quality and duration of remission, duration of disease, years of education and FSS were tested with generalised linear models using Gamma regression with log-link function. <h3>Results</h3> We included 106 female SLE patients (age: 28.9±7.6 years; duration of disease: 45.1±34.8 months; years of education: 9.6±5.2; depression present in 41 (38.7%)) and 98 female controls (age: 30.4±7 years; years of education: 10.8±6.2; depression present in 32 (32.7%)). At last visit, clinical remission was present in 68 (64.2%) and complete remission in 38 (35.2%). Duration of remission achieved were:&lt;1 year in 17 (16%), 1–2 years in 40 (37.7%), 2–3 years in 18 (17%) and &gt;3 years in 31 (29.2%). Steroid-free remission was present in 64 (60.37%) and the rest 42 (39.62%) were on ≤5 mg/d prednisolone. All were on hydroxychloroquine. A stable dose of 2nd immunosuppressive drug was present in 54 (50.94%) with 3 on stable dose of mycophenolate and 51 on azathioprine. SLE patients had comparable SF-12 PCS (48.4±8.1 vs 47.1±7, p=0.098) and MCS (57.7±3.4 vs 56.6±5.6, p=0.199) as compared to controls. Among lupus patients, both PCS (r=– 0.616, p&lt;0.001) and MCS (r=– 0.298, p&lt;0.001) were correlated with FSS and years of education (with PCS, r=– 0.215, p=0.027; with MCS, r=– 0.269, p=0.005). Independent predictors of PCS were: clinical remission (Odd's ratio (OR) 0.95, 95% confidence interval (CI) 0.92–0.99, p=0.033), FSS (OR 0.90, 95% CI 0.89–0.92, p&lt;0.001) and disease duration &lt;5 years (OR 0.92, 95% CI 0.86–0.97, p=0.006). Independent predictors of MCS were: FSS (OR 0.991, 95% CI 0.983–0.999, p=0.025), years of education (OR 0.998, 95% CI: 0.995–0.999, p=0.028) and disease duration &lt;5 years (OR 1.053, 95% CI 1.018–1.089, p=0.003). Estimated marginal means of PCS and MCS against quality of remission and duration of disease are plotted in figure 1. <h3>Conclusions</h3> Indian lupus patients in durable remission had similar physical and mental QoL compared to healthy controls. Physical QoL was better in patients with complete remission, longer disease duration and low fatigue. Mental QoL was better in patients with low fatigue, less education and longer disease duration. <h3>Disclosure of Interest</h3> None declared