CS-23 Remission and low disease activity state are associated with a better health-related quality of life in systemic lupus erythematosus in a primarily mestizo population

Francisco Zevallos,Rocio V Gamboa-Cardenas,Cesar A Pastor-Asurza,Cristina Reátegui-Sokolova,Graciela S Alarcón,Jose Alfaro-Lozano,Claudia Elera-Fitzcarrald,Mariela Medina-Chinchón,Manuel F Ugarte-Gil,Victor Pimentel-Quiroz,Risto Perich-Campos,Zoila Rodriguez-Bellido

doi:10.1136/lupus-2018-lsm.58

Abstract

Background Achieving remission or low lupus disease activity state (LDAS) in systemic lupus erythematosus (SLE) patients improves their prognosis in terms of damage accrual. But, there is not enough information about their impact on health-related quality of life (HRQoL). The aim of these analyses is to evaluate the association between remission or LDAS and HRQoL, after adjustment for possible confounders. Methods The Almenara Lupus Cohort was started in 2012; all patients evaluated at the Rheumatology Department were invited to participate. Visits were performed every six months. Socioeconomic and clinical data were recorded at every visit. Disease activity was ascertained with the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), disease damage with the SLICC/ACR Damage Index (SDI) and HRQoL was measured with the LupusQoL. For theses analyses, data from the baseline visit were included. Remission was defined as a SLEDAI-2K=0, prednisone ≤5 mg/d, immunosuppressants on maintenance dose, LDAS was defined as not on remission and a SLEDAI-2K≤4, prednisone ≤7.5 mg/d, immunosuppressants on maintenance dose. Univariable and multivariable lineal regression models, adjusted by age at diagnosis, disease duration, socioeconomic status, antimalarial use, disease duration, time of exposure to prednisone, damage and comorbidities were performed. Due to the relatively small number of patients on remission, remission and LDAS were analyzed together. Results Two hundred and eighty patients were included, 259 (92.5%) were female, mean age at diagnosis was 35.4 (SD=13.5) years, disease duration was 7.2 (6.5) years. Forty-five (16.1%) were on remission, 94 (33.6%) were on LDAS. Being on remission or LDAS was associated with a better HRQoL in the following domains, independently of possible confounders: physical health, planning, emotional health and body image. Univariable and multivariable analyses are depicted in table 1. Conclusions Being on remission or LDAS is associated with a better HRQoL independently of possible confounders.

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