154 Impact of diagnosis age on quality of life among patients with systemic lupus erythematosus

Abstract

Background While systemic lupus erythematosus (SLE) disproportionately affects minority women of child-bearing age, 1520% of all patients with SLE are diagnosed as children. Studies have shown that patients with SLE perceive their quality of life as poorer than the general public due to the impact of the disease on aspects of their physical, social, and psychological function. This study compares the health-related quality of life (HRQOL) in childhood-onset SLE (cSLE), defined as diagnosed prior to age 18, to HRQOL in adult-onset SLE (aSLE). Methods Data was collected as part of an ongoing longitudinal SLE registry at MUSC, including demographics, clinical disease manifestations and patient-reported responses to the Short Form-36 (SF-36) v2 questionnaire. For this study, the initial SF-36 v2 questionnaire completed at time of registry enrollment after age 18 was utilized, excluding patients with less than 4 ACR Classification Criteria for SLE and patients missing SF-36 v2 data. Scores were analyzed across four physical health and four mental health domains. SF-36 v2 mean scores were compared between cSLE patients and aSLE patients. Results The mean normalized scores for all four SF-36 v2 physical health domains were higher for cSLE patients compared to aSLE patients as seen in table 1. There was statistical significance found in two domains of physical health: physical functioning (52.1±6.1 cSLE vs 38.8±12.4 aSLE, p=0.002) and role physical (50.1±7.1 cSLE vs 38.5±12.5 aSLE, p=0.007). The mean normalized scores for all four SF-36 v2 mental health domains were also higher for cSLE patients compared to aSLE patients, but no statistical significance was found. Conclusions Despite the association among patients with SLE between childhood-onset and a more severe disease course, our findings showed an overall higher health related quality of life within the cohort. These findings suggest that having been diagnosed at an earlier age and having lived most of their life with a systemic autoimmune disease may contribute to the higher quality of life reported by patients with cSLE. Funding Source(s): This work has been supported by funding from the Rheumatology Research Foundation 2016 Medical Student Research Preceptorship (CLK) and the National Institutes of Health: Medical University of SC Clinical and Translational Science Award UL1 RR029882 and National Institute of Arthritis and Musculoskeletal and Skin Diseases Award P60 AR062755 (GSG, JCO, DLK) and K24 AR068406 (DLK), and the VA Medical Service at the Ralph H. Johnson VA Medical Center (GSG, and JCO).