AB0641 Correlation between physicians and patients in the assessment of disease activity in systemic lupus erythematosus
Authors: Y. Nasa, N. Yokokawa, H. Takahashi, E. Takamasu, S. Sugii
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> In the assessment of systemic lupus erythematosus (SLE), laboratory data and clinical findings have been more focused than patient-reported outcomes which reflect quality of Life. Previous studies showed discrepancy between patients and physicians in assessments of disease activity in SLE.<sup>1</sup> The Systemic Lupus Activity Questionnaire (SLAQ), a lupus disease activity index which consisted of only patient reported outcomes, and SLE Disease Activity Index 2000 (SLEDAI-2K) were poorly corelated.<sup>2</sup> <h3>Objectives</h3> We aimed to investigate the correlation between SLAQ and SLEDAI-2K scores in those who had discordance between patients' VAS and physicians' VAS or not. <h3>Methods</h3> Both SLEDAI-2K and SLAQ were routinely measured at every outpatient visit in all SLE patients. We analysed the data between 9/12/2017 and 12/31/2017. Patients were divided into concordance(|patients' VAS-physicians' VAS|&lt;25) or discordance group (|patients' VAS-physicains' VAS|≧25).<sup>3</sup> We measured correlation between SLAQ score vs SLEDAI-2K or SLEDAI-2K-nolab scores by Spearman's correlation in the concordance group and the discordance group. Comparison between the concordance group and the discordance group were perfomed using chi-squared test for categorical variables and Student t-test, Welch's t-test or Mann-Whitney U test for continuous variables. <h3>Results</h3> Total 130 patients were analysed; 91% of female, a mean age (SD) of 44<sup>15</sup> years, steroid use of 91%, immunosuppressant use of 54%, HCQ use of 70%. Median SLAQ, SLEDAI-2K and SLEDAI-2K-nolab scores were 4 [IQR: 2–7], 4 [IQR: 2–4] and 0 [IQR: 0–2], respectively. Among them, 86 (66%) were classified in the concordance group. The SLAQ scores were weakly correlated with the SLEDAI-2K scores (ρ=0.228, p=0.009), and with SLEDAI-2K-nolab scores (ρ=0.352, p&lt;0.001). In the concordance group, the SLAQ scores correlated with SLEDAI-2K scores (ρ=0.327, p=0.002) and SLEDAI-2K-nolab scores (ρ=0.523, p&lt;0.001). The pain VAS and RAPID3 in the discordance group were significantly higher than those in the concordance group (30.77±26.54 vs 10.71±14.31, p&lt;0.001, 8.11±5.87 vs 2.97±3.23, p&lt;0.001, repectively). In the discordance group, the SLAQ scores were not correlated with SLEDAI-2K scores (ρ=−0.029, p=0.849) and with SLEDAI-2K-nolab scores (ρ=−0.083, p=0.957). <h3>Abstract AB0641 – Table 1.</h3> LLDAS: Lupus low Disease Activity State *Student t-test **Welch's t-test ¶Mann-Whitney U test <h3>Conclusions</h3> The correlation between SLAQ vs SLEDAI-2K or SLEDAI-2K-nolab scores was exhibited in the concordance group. Musculoskeletal pain may be associated with the discordance between patients' and physicians' assessment. <h3>References</h3> [1] Karlson EW, et al. Vlidation of a Systemic Lupus Activity Questionnaire(SLAQ) for population studies. Lupus2003;12:280–286. [2] Okamoto Y, et al. Validation of the Japanese version of the Systemic Lupus Activity Questionnaire that includes physician-based assessments in a large observational cohort. Lupus2016;25:486–495. [3] Barton JL, et al. Patient-physician discordance in assessments of a global disease severity in rheumatoid arthritis. Arthritis Care Res2010;62:857–64. <h3>Disclosure of Interest</h3> None declared