Abstract

BackgroundSystemic Lupus Erythematosus (SLE) has diverse effects on patients' health-related quality-of-life (HRQoL), affecting both physical and mental domains of well-being. The Medical Outcomes Survey 36-item Short Form (SF-36) is one of the most common generic instruments used to measure HRQoL in SLE.ObjectivesOur objective in this study is to assess the aspects of HRQoL in patients with SLE and to explore the associations between HRQoL and disease-related parameters.MethodsA cross-sectional study was conducted in patients followed in the departments of Internal Medicine and Rheumatology in Mahdia, Tunisia, who met either the 1997 ACR or the 2012 SLICC criteria for SLE. We evaluated for each patient, the global score and the eight domains of SF-36 (physical functioning (PF), role physical (RP), bodily pain (BP) and general health (GH) gathered into the Physical Component Summary (PCS); vitality (VT), social functioning (SF), role emotional (RE) and mental health (MH)) gathered into Mental component Summary (MCS), scored from 0 (worst) to 100 (best). The disease activity was evaluated by the SLE Disease Activity Index (SLEDAI).ResultsForty SLE patients were enrolled. 90% of patients were female. The mean age was 47.75±17.59 years. The mean disease duration was 2.3±2.9 years. The mean SLEDAI was 5.78±4.94. The most commonly found manifestations of SLE were; cutaneous, musculoskeletal and neuro-psychiatric in 85%, 82.5% and 40% of cases, respectively. The anti-nuclear antibodies were positive in 100% of cases. Serum levels of complement C3 and C4 were low in 20% and 32.5% of cases, respectively. A biological inflammatory syndrome was found in 37.5% of cases and anemia in 42.5% of cases. Anti-malarial were prescribed for 85% of patients, Glucocortoids were prescribed for 62.5% of patients. The SF-36 global score was 60.5 ± 20.5 ranging from 18.5 to 93.1. Eighteen patients (45 %) had impaired HRQoL (SF-36 < 66.7). The physical domains were more affected than the mental ones with mean scores of PCS and MCS of 59.59 and 61.6, respectively. The means of different domains (PF, RP, BP, GH, VT, SF, RE and MH) were respectively 67.87±28.3; 52.5±50; 62.5±29; 55.49±25.6; 56±21.5; 64±25.7; 67.5 ±47.4 and 58.6±18.6. The most severely impacted domains were RP and GH. Increased age was correlated with reduced PF, BP and PCS (p=0.02, p=0.02, p=0.05 respectively). Longer disease duration was associated with reduced GH (p=0.004). The analysis of organ-specific damage revealed that musculoskeletal involvement was significantly associated with lower scores of PF, RP, BP and PCS (p=0.05, p=0.009, p=0.01 and p<0.001, respectively), While neurological involvement was associated with lower scores of SF, VT and MCS (p=0.01, p=0.05 and p=0.04, respectively). The SF-36 global score and its domains had no significant correlations with the SLEDAI, the biological abnormalities or the received treatments.ConclusionImpairment in the quality of life can be significant when suffering from SLE, affecting physical health more than mental health according to our study. HRQoL should be included in routine clinical care in SLE patients.Disclosure of InterestsNone declared

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