Severe flares are associated with a poorer health-related quality of life (HRQoL) in patients with SLE: data from the Almenara Lupus Cohort

Background Flares in patients with SLE, regardless of their severity, have been associated with damage accrual. However, their impact on health-related quality of life (HRQoL) has not been fully evaluated. In fact, disease activity is only minimally associated with HRQoL.Objective To determine the a...

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Main Authors: Manuel Francisco Ugarte-Gil, Graciela S Alarcón, Risto Alfredo Perich-Campos, Claudia Elera-Fitzcarrald, Cristina Reátegui-Sokolova, Rocio Violeta Gamboa-Cardenas, Mariela Medina, Victor Román Pimentel-Quiroz, Cesar Augusto Pastor-Asurza
Format: Article
Language:English
Published: BMJ Publishing Group 2022-05-01
Series:Lupus Science and Medicine
Online Access:https://lupus.bmj.com/content/9/1/e000641.full
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author Manuel Francisco Ugarte-Gil
Graciela S Alarcón
Risto Alfredo Perich-Campos
Claudia Elera-Fitzcarrald
Cristina Reátegui-Sokolova
Rocio Violeta Gamboa-Cardenas
Mariela Medina
Victor Román Pimentel-Quiroz
Cesar Augusto Pastor-Asurza
author_facet Manuel Francisco Ugarte-Gil
Graciela S Alarcón
Risto Alfredo Perich-Campos
Claudia Elera-Fitzcarrald
Cristina Reátegui-Sokolova
Rocio Violeta Gamboa-Cardenas
Mariela Medina
Victor Román Pimentel-Quiroz
Cesar Augusto Pastor-Asurza
author_sort Manuel Francisco Ugarte-Gil
collection DOAJ
description Background Flares in patients with SLE, regardless of their severity, have been associated with damage accrual. However, their impact on health-related quality of life (HRQoL) has not been fully evaluated. In fact, disease activity is only minimally associated with HRQoL.Objective To determine the association between flares and HRQoL.Methods Patients from the Almenara Lupus Cohort were included. Visits occurring between December 2015 and February 2020 were evaluated. Flares were defined as an increase on the SLE Disease Activity Index 2000 (SLEDAI-2K) of at least 4 points; severe flares were those with a final SLEDAI-2K ≥12 and mild-moderate flares all the others. HRQoL was measured using the LupusQoL. Univariable and multivariable generalised estimating regression equations were performed, adjusting for possible confounders. Confounders were determined at one visit, whereas the outcome was determined on the subsequent visit; flares were determined based on the variation of the SLEDAI-2K between these visits.Results Two hundred and seventy-seven patients were included; 256 (92.4%) were female, mean age at diagnosis was 36.0 (SD: 13.3) years and mean disease duration at baseline was 9.1 (SD: 7.1) years. Patients had mean of 4.8 (SD: 1.9) visits and a mean follow-up of 2.7 (1.1) years. Out of 1098 visits, 115 (10.5%) flares were defined, 17 were severe and 98 mild-moderate. After adjustment for possible confounders, only severe flares were associated with a poorer HRQoL in planning, pain, emotional health and fatigue.Conclusions Severe flares, but not mild-moderate, flares are associated with poorer HRQoL.
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spelling doaj.art-2606d90e58154cd8ae4835246fd5aec82023-07-08T09:00:07ZengBMJ Publishing GroupLupus Science and Medicine2053-87902022-05-019110.1136/lupus-2021-000641Severe flares are associated with a poorer health-related quality of life (HRQoL) in patients with SLE: data from the Almenara Lupus CohortManuel Francisco Ugarte-Gil0Graciela S Alarcón1Risto Alfredo Perich-Campos2Claudia Elera-Fitzcarrald3Cristina Reátegui-Sokolova4Rocio Violeta Gamboa-Cardenas5Mariela Medina6Victor Román Pimentel-Quiroz7Cesar Augusto Pastor-Asurza8Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémicas, Universidad Científica del Sur, Lima, PeruMedicine, Division of Clinical Immunology and Rheumatology, The University of Alabama at Birmingham, Birmingham, Alabama, USARheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, PeruRheumatology, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, PeruUnidad de Investigación Para La Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, PeruRheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, PeruRheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, PeruRheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, PeruRheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, PeruBackground Flares in patients with SLE, regardless of their severity, have been associated with damage accrual. However, their impact on health-related quality of life (HRQoL) has not been fully evaluated. In fact, disease activity is only minimally associated with HRQoL.Objective To determine the association between flares and HRQoL.Methods Patients from the Almenara Lupus Cohort were included. Visits occurring between December 2015 and February 2020 were evaluated. Flares were defined as an increase on the SLE Disease Activity Index 2000 (SLEDAI-2K) of at least 4 points; severe flares were those with a final SLEDAI-2K ≥12 and mild-moderate flares all the others. HRQoL was measured using the LupusQoL. Univariable and multivariable generalised estimating regression equations were performed, adjusting for possible confounders. Confounders were determined at one visit, whereas the outcome was determined on the subsequent visit; flares were determined based on the variation of the SLEDAI-2K between these visits.Results Two hundred and seventy-seven patients were included; 256 (92.4%) were female, mean age at diagnosis was 36.0 (SD: 13.3) years and mean disease duration at baseline was 9.1 (SD: 7.1) years. Patients had mean of 4.8 (SD: 1.9) visits and a mean follow-up of 2.7 (1.1) years. Out of 1098 visits, 115 (10.5%) flares were defined, 17 were severe and 98 mild-moderate. After adjustment for possible confounders, only severe flares were associated with a poorer HRQoL in planning, pain, emotional health and fatigue.Conclusions Severe flares, but not mild-moderate, flares are associated with poorer HRQoL.https://lupus.bmj.com/content/9/1/e000641.full
spellingShingle Manuel Francisco Ugarte-Gil
Graciela S Alarcón
Risto Alfredo Perich-Campos
Claudia Elera-Fitzcarrald
Cristina Reátegui-Sokolova
Rocio Violeta Gamboa-Cardenas
Mariela Medina
Victor Román Pimentel-Quiroz
Cesar Augusto Pastor-Asurza
Severe flares are associated with a poorer health-related quality of life (HRQoL) in patients with SLE: data from the Almenara Lupus Cohort
Lupus Science and Medicine
title Severe flares are associated with a poorer health-related quality of life (HRQoL) in patients with SLE: data from the Almenara Lupus Cohort
title_full Severe flares are associated with a poorer health-related quality of life (HRQoL) in patients with SLE: data from the Almenara Lupus Cohort
title_fullStr Severe flares are associated with a poorer health-related quality of life (HRQoL) in patients with SLE: data from the Almenara Lupus Cohort
title_full_unstemmed Severe flares are associated with a poorer health-related quality of life (HRQoL) in patients with SLE: data from the Almenara Lupus Cohort
title_short Severe flares are associated with a poorer health-related quality of life (HRQoL) in patients with SLE: data from the Almenara Lupus Cohort
title_sort severe flares are associated with a poorer health related quality of life hrqol in patients with sle data from the almenara lupus cohort
url https://lupus.bmj.com/content/9/1/e000641.full
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