Objective. The Medical Outcomes Study Short Form 36 (SF-36) is recommended to assess quality of life (QOL) in systemic lupus erythematosus (SLE).The aim of the current study was to assess QOL over time in the first 5 years of a multicenter inception cohort of patients with SLE.Methods. An inception SLE cohort was assembled according to a standardized protocol between 2000 and 2012. In addition to clinical and laboratory assessments, patients completed the SF-36 at yearly intervals. Only patients who had >5 completed QOL questionnaires were included in these analyses. Generalized estimating equation models were run separately for each of the 8 subscales and for the physical and mental component summary scores, adjusting for repeated measures by patients. Results. A total of 495 patients were included. The mean ؎ SD disease duration at the first visit was 5.3 ؎ 4.1 months. The mean ؎ SD age at enrollment was 35.8 ؎ 13.2 years. All 8 subscales and the 2 summary scores showed improvement in the first 2 years from enrollment. Between years 2 and 5, none of the subscales or summary scores showed any change. Minimum clinically important improvement was achieved by 35-56% of the patients and was influenced by demographic and disease factors. Conclusion. Unlike late-stage lupus, where QOL is stable over time, in patients with early disease, all subscales improve in early followup up to 2 years. Therefore, the SF-36 may be a sensitive outcome measure in early disease in patients with SLE.
To assess the associations between agerelated macular degeneration (ARMD) and smoking. Methods: The POLA study is a population-based study taking place in the town of Sète, located on the French Mediterranean Sea border. The presence of early and late ARMD was assessed in 2196 participants on the basis of 50°color fundus photographs using an international classification system. Results: After adjustment for age and sex, current and former smokers showed an increased prevalence of late ARMD (odds ratio [OR] = 3.6, 95% confidence interval [CI] = 1.1-12.4; OR = 3.2, 95% CI = 1.3-7.7, respectively). An increased risk was present in participants who smoked more than 20 pack-years (OR = 3.0, 95% CI = 0.9-9.5 for 20-39 pack-years; OR = 5.2, 95% CI = 2.0-13.6 for 40 pack-years and more). In addition, the risk of late ARMD remained increased until 20 years after cessation of smoking (OR = 9.0, 95% CI = 3.0-27.0 for 1-9 years; OR = 4.0, 95% CI = 1.3-12.0 for 10-19 years; OR = 1.3, 95% CI = 0.4-4.3 for 20 years and more). Smoking was not significantly associated with early signs of ARMD. Conclusions: This study further confirms the adverse effect of tobacco on late ARMD. Former smokers seem to remain at high risk for ARMD.
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