THU0285 ANALYSIS OF THE RELATIONSHIP BETWEEN ORGAN DAMAGE AND QUALITY OF LIFE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: Y. Takase, H. Doi, T. Iwasaki, M. Hashimoto, R. Inaba, T. Kozuki, M. Taniguchi, Y. Tabuchi, K. Kitagori, S. Akizuki, K. Murakami, R. Nakashima, H. Yoshifuji, W. Yamamoto, M. Tanaka, K. Ohmura
Journal: Annals of the Rheumatic Diseases (2020)

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease that can not only cause systemic symptoms, such as fever and arthritis, but can also damage important organs, such as those of the central nervous system and the kidneys. Prevention of irreversible organ damage is important for better prognosis [1]. Additionally, the importance of maintaining the quality of life (QOL) of patients has recently been emphasized. However, only a few studies have examined the relationship between irreversible organ damage and patient QOL. Objectives: To assess the relationship between organ damage and QOL, and to survey which organs have more significant effects on QOL. Methods: We conducted a questionnaire-based survey of 183 patients with SLE at Kyoto University Hospital from September to December 2019. We used the SLICC/ACR Damage Index (SDI) to evaluate organ damage [2]. The following five scales were employed to evaluate QOL: the physical (PCS) and mental component summary (MCS) of the Medical Outcome Study (MOS) 36-Item Short-Form Health Survey version 2.0 (SF-36v2) [3], health (HRQOL) and non-health-related QOL (N-HRQOL) of LupusPRO [4], and SLE Symptom Checklist (SSC) [5]. Results: Linear regression analysis showed significant correlation between the SDI score and all QOL scales except for N-HRQOL, suggesting negative effects of organ damage on QOL (Table 1). Next, we analysed whether there was a significant difference in the SF-36 score between those who were positive and negative for each SDI item (41 in total), using the Wilcoxon rank sum test. Muscle atrophy or weakness ( p = 3.0×10 -10 ), osteoporosis with fracture or vertebral collapse ( p = 9.7×10 -8 ), claudication ( p = 7.4×10 -5 ), and cognitive impairment or major psychosis ( p = 9.9×10 -5 ) significantly correlated ( p &lt; 1.2×10 -3 ) with PCS, and scarring chronic alopecia ( p = 3.4×10 -4 ) with MCS (Table 2). In addition, the five SDI items significantly correlated with the remaining three QOL scales (HRQOL, N-HRQOL, and SSC; p &lt; 0.05). Table 1. Relationship between the SDI score and QOL SF-36 LupusPRO SSC PCS MCS HRQOL N-HRQOL p -value &lt;2.0×10 -16 1.7×10 -3 2.2×10 -11 0.23 1.9×10 -8 Table 2. Relationship between each SDI item and the SF-36 score ( p &lt; 1.2×10 -3 SDI item PCS score p -value Positive (Median (IQR)) Negative (Median (IQR)) Muscle atrophy/weakness 33 (19-45) 50 (43-54) 3.0×10 -10 Osteoporosis with fracture/vertebral collapse 24 (12-32) 49 (38-54) 9.7×10 -8 Claudication 31 (19-35) 49 (38-54) 7.4×10 -5 Cognitive impairment/psychosis 27 (17-33) 49 (38-54) 9.9×10 -5 SDI item MCS score p -value Positive (Median (IQR)) Negative (Median (IQR)) Scarring chronic alopecia 42 (29-51) 49 (39-54) 3.4×10 -4 Conclusion: We demonstrated that organ damage has negative effects on patient QOL, indicating the importance of preventing irreversible organ damage for maintaining QOL. Moreover, muscle atrophy/weakness, osteoporosis with fracture/vertebral collapse, claudication, cognitive impairment/major psychosis, and scarring chronic alopecia significantly correlated with QOL deterioration, suggesting that these items should be examined with special care in clinical practice. References: [1]Lopez R, et al. Rheumatology (Oxford). 2012; 51:491-498. [2]Gladman D, et al. Arthritis Rheum. 1996; 39:363-369. [3]Fukuhara S, et al. J Clin Epidemiol. 1998; 51:1037-1044. [4]Inoue M, et al. Lupus. 2017; 26:849-856. [5]Grootscholten C, et al. Qual Life Res. 2003; 12:635–644. Disclosure of Interests: Yudai Takase: None declared, Hiroshi Doi: None declared, Takeshi Iwasaki: None declared, Motomu Hashimoto Grant/research support from: Bristol-Myers Squibb, Eisai, and Eli Lilly and Company., Speakers bureau: Bristol-Myers Squibb and Mitsubishi Tanabe Pharma., Ryuta Inaba: None declared, Tomohiro Kozuki: None declared, Masashi Taniguchi: None declared, Yuya Tabuchi Paid instructor for: Astellas Pharma, GlaxoSmithKline, Mitsubishi Tanabe Pharma, and Nippon Shinyaku., Speakers bureau: AbbVie, Janssen Pharmaceutical, Mitsubishi Tanabe Pharma, Nippon Shinyaku, and Novartis Pharma. (Outside the field of the present study.), Koji Kitagori: None declared, Syuji Akizuki: None declared, Kosaku Murakami Speakers bureau: AbbVie, Eisai, and Mitsubishi Tanabe Pharma., Ran Nakashima Grant/research support from: Takeda Pharmaceutical. (Outside the field of the present study.), Speakers bureau: Astellas Pharma, Medical &amp; Biological Laboratories, AstraZeneca, and Boehringer Ingelheim. (Outside the field of the present study.), Hajime Yoshifuji Grant/research support from: Astellas Pharma. (Outside the field of the present study.), Speakers bureau: Chugai Pharmaceutical. (Outside the field of the present study.), Wataru Yamamoto: None declared, Masao Tanaka Grant/research support from: AbbVie, Asahi Kasei Pharma, Astellas Pharma, Ayumi Pharmaceutical, Chugai Pharmaceutical, Eisai, Mitsubishi Tanabe Pharma, Taisho Pharmaceutical, and UCB Japan. , Speakers bureau: AbbVie, Asahi Kasei Pharma, Astellas Pharma, Bristol-Myers Squibb, Chugai Pharmaceutical, Eisai, Eli Lilly and Company, Janssen Pharmaceutical, Mitsubishi Tanabe Pharma, Novartis Pharma, Pfizer, Taisho Pharmaceutical, Takeda Pharmaceutical, and UCB Japan., Koichiro Ohmura Grant/research support from: Astellas Pharma, AYUMI Pharmaceutical, Chugai Pharmaceutical, Daiichi Sankyo, Eisai, Japan Blood Products Organization, Mitsubishi Tanabe Pharma, Nippon Kayaku, Nippon Shinyaku, Sanofi, and Takeda Pharmaceutical., Speakers bureau: AbbVie, Actelion Pharmaceuticals Japan, Asahi Kasei Pharma, AYUMI Pharmaceutical, Bristol-Myers Squibb, Chugai Pharmaceutical, Eisai, Eli Lilly and Company, GlaxoSmithKline, Janssen Pharmaceutical, Mitsubishi Tanabe Pharma, Novartis Pharma, and Sanofi.