AB1008 BRIDGING THE GAP BETWEEN PATIENT’S PERCEPTION ON QUALITY OF LIFE AND DISEASE ACTIVITY AND DAMAGE IN SYSTEMIC LUPUS ERYTHEMATOUS PATIENTS
Authors: D. Fernández Fernández, I. L. Mamani Velarde, Í. Rúa-Figueroa, K. Roberts, C. Mouriño Rodríguez, R. Menor-Almagro, J. Martínez-Barrio, A. Olivé, P. Rubio-Muñoz, M. Galindo-Izquierdo, A. Fernández-Nebro, J. Calvo Alén, C. Erausquin, E. Tomero Muriel, E. Uriarte Isacelaya, A. Pecondon-Español, M. Freire González, R. Blanco, L. Expósito, M. Ibañez Barceló, C. Montilla, J. Rosas Gómez de Salazar, M. J. Garcia-Villanueva, P. Vela Casasempere, O. Ibarguengoitia, F. J. Toyos Sáenz de Miera, J. A. Hernandez Beriain, C. Moriano, G. Bonilla, J. Narváez, J. L. Andréu Sánchez, M. Arévalo, L. Horcada, T. Cobo-Ibáñez, N. Lozano Rivas, C. Bohorquez, C. L. Iñíguez, E. Salgado Perez, V. Torrente-Segarra, T. C. Salman-Monte, J. Eloy Oller, J. M. Pego-Reigosa
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Improving quality of life (QoL) is one of the key targets when treating systemic lupus erythematosus (SLE) patients. The Lupus impact Tracker (LIT) is a 10-item questionnaire that has demonstrated being a reliable and valid tool to assess the impact [1] of the disease in SLE patients. LIT may range between 0 (no impact on QoL) and 100 (maximum impact on QoL). <h3>Objectives:</h3> To analyze the variables potentially associated with a greater influence on QoL (higher LIT score) in SLE patients <h3>Methods:</h3> The study population corresponds to RELESSER-PROS prospective cohort with data from patients at their first annual visit (V1). The LIT score was divided into 4 groups based on the quartile distribution, and the distribution of variables in each of the 4 groups was analysed. The Chi-square or Fisher test was used for categorical variables, while ANOVA or Kruskal-Wallis tests were employed for continuous variables. Subsequently, a logistic regression model was fitted to analyse the variables influencing the presence of LIT scores greater than 50 points. A significance level of 5% was used for the entire analysis, and the R software was employed. <h3>Results:</h3> A total of 1417 SLE patients were prospectively included in the study: 1275 (90%) female/142 (10%) male; 1299 (94.2%) Caucasian. The mean (±SD) age at SLE diagnosis and at study entry (V1) were 34.7 (±13.9) and 56.0 (±1.0) years, respectively. The median (Q1-Q3) value of LIT at V1 was 25 (10-47.5). The domains of LIT who scored the most for the final value were "<i>pain/fatigue</i>" with a mean (±SD) score per question: 1.52 (±1.07) and "<i>emotional health</i>" with 1.29 (±1.18). On the other hand, the domains of LIT that scored the least were "<i>body image dissatisfaction"</i> and "<i>lupus medication adverse effects</i>" with 0.87 (±1.20) and 0.69 (±1.09) per question, respectively. At V1, the mean (±SD) clinical (without serology) SLEDAI score was 1.92 (±3.26) and the mean (±SD) SLE Damage Index (SDI) score was 1.42 (±1.77). We observed significantly higher cSLEDAI and SDI scores in the subgroup of patients with higher (50,100) LIT values (Table 1). When we performed a bivariant correlation analysis between LIT score and both cSLEDAI and SDI we observed that correlation was low: Spearman's Correlation Coefficient 0.093 and 0.17, respectively. We observed that patients with higher LIT values were less likely in LLDAS and in 2021 DORIS remission (p=0.04 for remission). We also analyse the influence of some variables other than activity and damage on QoL of SLE patients such as educational and laboral status, comorbidities (chronic obstructive, pulmonary disease, dyslipemia, fibromyalgia, depression, thyroid disease, cardiovascular comorbidity and gastroduodenal ulcer) and therapies (glucocorticoid treatment and doses, immunosuppressive therapy, antimalarial treatment and biologic therapy). We carried out a multivariant analysis with the previously mentioned variables, defining "LIT score &gt; 50" as the dependent variable. Table 2 shows the variables with significant independent association with a higher impact of SLE on QoL in the multivariate analysis. <h3>Conclusion:</h3> SLE has a significant impact on QoL of the patients, "<i>pain/fatigue</i>" and "<i>emotional health</i>" being the domains of QoL affected the most. Beyond activity and damage, comorbidities such as fibromyalgia, depression and thyroid disease as well as being on higher daily dose of prednisone are significantly associated with higher impact on QoL of SLE patients. On the other hand, some socioeconomic variables and being on hydroxychloroquine are significantly associated with better QoL. These results highlight the relevance of considering these factors when making clinical decisions, with the purpose of optimizing medical care of SLE patients. <h3>REFERENCES:</h3> [1] Jolly M, Garris CP, Mikolaitis RA, et al. Development and validation of the Lupus Impact Tracker: a patient-completed tool for clinical practice to assess and monitor the impact of systemic lupus erythematosus. <i>Arthritis Care Res (Hoboken</i>). 2014;66(10):1542-1550. doi:10.1002/acr.22349 <h3>Acknowledgements:</h3> The RELESSER Registry was supported by the Spanish Society of Rheumatology. This work was supported by the grant Fondo de Investigaciones sanitarias/Instituto de Salud Carlos III (FIS/ISCIII)-Fondo Europeo de Desarrollo regional (FEDER) (Grant number PI11/02857). RELESSER PROS is funded by GSK. <h3>Disclosure of Interests:</h3> <b>None declared.</b>