POS0737 HIGHER HEALTH-RELATED QUALITY OF LIFE MEASURED BY LUPUS PATIENT-REPORTED OUTCOME WAS ASSOCIATED WITH LOWER INCREASE IN DAMAGE ACCRUAL IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A LONGITUDINAL STUDY USING THE JAPANESE MULTICENTER REGISTRY
Authors: Y. Nose, A. Onishi, K. Nishimura, Y. Yamamoto, H. Yamada, S. Sendo, Y. Ueda, K. E. Sada, K. Ichinose, R. Yoshimi, S. Ohno, N. Yajima, H. Kajiyama, S. Sato, Y. Shimojima, M. Fujiwara, T. Kida, Y. Miyawaki, Y. Matsuo, H. Tsuji, A. Morinobu, J. Saegusa
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Patient-reported outcomes (PROs) are associated with prognosis and commonly used as a component of disease activity measurements and core sets of outcomes in several connective tissue diseases. However, there is no single PRO tool that is universally accepted as the gold standard in patients with systemic lupus erythematosus (SLE) [1], and the predictive validity of PRO tools for SLE-specific quality of life (QOL) has not been examined. <h3>Objectives:</h3> To examine the predictive validity of LupusPRO [2,3], one of PRO tools to assess the SLE-specific QOL, for damage accrual in patients with SLE using a longitudinal multicenter cohort study. <h3>Methods:</h3> Patients with SLE enrolled in the nationwide multicenter registry in Japan (LUNA) with ≥2 LupusPRO measurements were included. The SLE-specific QOL was assessed using the Japanese version of the LupusPRO questionnaire which contains both health-related (HR)-QOL and non-HR-QOL measures. The damage accrual was evaluated as an outcome using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). We examined the association between the LupusPRO score at baseline and longitudinal SDI scores using mixed-effects models adjusted for prognostic factors, such as age, sex, disease duration, disease activity, and medications. <h3>Results:</h3> Among 1295 patients (88.6% women, mean age 47.4 years), both the SDI scores and HR-QOL of LupusPRO were increased with the median follow-up of 2.0 years while the SLE disease activity index 2000 scores were decreased according to the treat-to-target strategy (Figure 1). Patients with higher HR-QOL of LupusPRO at baseline demonstrated a significantly lower increase in SDI (-0.005/year, 95% confidence interval: -0.007 to -0.004, p&lt;0.001, Table 1). According to categorization of HR-QOL based on tertile, a similar dose-dependent effect of HR-QOL on longitudinal SDI was identified (2nd vs. 1st tertile category: -0.101/year, 95% confidence interval: -0.172 to -0.030, p=0.005; 3rd vs. 1st tertile category: -0.211/year, 95% confidence interval: -0.281 to -0.142, p&lt;0.001, Table 1). Among HR-QOL domains, cognition, procreation, and physical health were significantly associated with total SDI score over time. HR-QOL was associated with both corticosteroid-dependent and -independent SDI scores. The association between HR-QOL and SDI was prominent in patients with the physician's global assessment score &lt;1 and with lupus low disease activity state. Non-HR-QOL was not significantly associated with SDI scores. <h3>Conclusion:</h3> Higher HR-QOL of LupusPRO was associated with lower increase in SDI scores. Because HR-QOL of LupusPRO measures seemed to provide unique information about the impact of disease that is not captured by physician-assessed measures, incorporating disease-specific QOL into a core set of outcomes in SLE may be warranted. <h3>REFERENCES:</h3> [1] van Tuyl LH et al. Patient-reported outcomes in core domain sets for rheumatic diseases. Nat Rev Rheumatol. 2015;11(12):705-12. [2] Jolly M et al. Disease-specific patient reported outcome tools for systemic lupus erythematosus. Semin Arthritis Rheum. 2012;42(1):56-65. [3] Inoue M et al. The Japanese LupusPRO: A cross-cultural validation of an outcome measure for lupus. Lupus. 2017;26(8):849-56. <b>Table 1.</b> The association between lupus patient-reported outcome and SLICC/ACR damage index scores. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>