ObjectivesMost indices of disease activity in SLE combine physicians’ assessments and laboratory tests. However, there is also a need to capture patients’ perspectives of disease activity. Consequently, we need new, preferably quick and easy instruments to collect this information, which can be very useful for online consultations and registry purposes. We compared patients’ assessments of SLE disease impact/activity, as reported by a shorter version of the Quick Systemic Lupus Activity Questionnaire (Q-SLAQ), with physicians’ assessments using SLE Activity Measure (SLAM) and SLE Disease Activity Index (SLEDAI-2K) and with the original Systemic Lupus Activity Questionnaire (SLAQ).MethodsPatients with SLE (n=115), with a disease duration of 15 years (IQR 17), completed the Q-SLAQ prior to physicians’ assessments by SLAM and SLEDAI-2K. A second set of patients (n=85) with similar characteristics filled out Q-SLAQ and SLAQ. Spearman’s ρ correlations were explored between patients’ total Q-SLAQ and subscales (Symptom Score, Patient’s Global Disease Activity) and physicians’ SLAM and SLEDAI-2K, with and without laboratory items (SLAM-nolab and SLEDAI-2K-nolab) and SLAQ. Corresponding items in Q-SLAQ and SLAM were compared.ResultsCorrelations between patients’ and physicians’ assessments were higher for SLAM-nolab (total Q-SLAQ, ρ=0.71; Symptom Score, ρ=0.67; and Patient’s Global Disease Activity, ρ=0.68) than for the original SLAM (total Q-SLAQ, ρ=0.53; Symptom Score, ρ=0.50; and Patient’s Global Disease Activity, ρ=0.53). Regarding specific symptoms, fatigue (ρ=0.72) and alopecia (ρ=0.71) correlated best, while pulmonary/respiratory symptoms correlated least (ρ=0.19, p=0.039). Physicians assessment with SLEDAI-2K-nolab correlated weakly with patients’ assessments (total Q-SLAQ, ρ=0.30; Symptom Score, ρ=0.30; and Patient’s Global Disease Activity, ρ=0.36). Bivariate correlations between Q-SLAQ and SLAQ were good (ρ=0.82–0.96).ConclusionsQ-SLAQ and the original SLAQ performed equally well, demonstrating that the shorter Q-SLAQ can safely be used to monitor patients’ perception of disease impact/activity. We also noted an intriguing discrepancy between physicians’ and patients’ evaluations of pulmonary/respiratory symptoms, which requires further investigations.
and social functions. The aim of this study was to assess the impact of disease activity on HRQoL. Methods This was a cross-sectional descriptive study conducted at Kenyatta National Hospital rheumatology and renal outpatient clinics. 62 patients fulfilling !4 Systemic Lupus International Collaborating Clinics Criteria (SLICC) 2012 for classification of SLE were consecutively recruited. 27 patients with overlap syndromes were excluded. Disease activity was assessed by the modified Systemic Lupus Erythematosus Disease Activity Index 2000 (cSLEDAI-2K). HRQoL was evaluated using self-administered LupusQoL with scores ranging from 0 (worst) to 100 (best). HRQoL was correlated with age, disease duration and disease activity. Data analysis was performed on SPSS version 23. Results The study comprised 60 female patients with mean age 34.7±11.8 years. The median disease duration was 36 months and ranged from 1-324 months. Mean cSLEDAI score was 7±5.2 and median disease activity score was 7. Renal involvement occurred in 53.2%. All domains of LupusQoL were impaired. The mean Lupus-QoL score was 56%±24.4 (figure 1). SLEDAI scores inversely correlated with scores of physical health, pain, burden to others, body image and general health. The patients with renal disease had significantly lower QoL compared to other patients. Age and disease duration were positively correlated with QoL. Disease duration was associated with a better QoL in the pain, emotional health and body image domains. Conclusions Our study showed a low HRQoL in those with active disease. Young age, a recent diagnosis of lupus and presence of renal disease was associated with a poorer QoL.
BackgroundThe Systemic Lupus Activity Questionnaire (SLAQ) is a validated questionnaire, which captures patients’ assessments of SLE-related symptoms and disease activity (1). However, it is extensive and in a recent study we found that some questions were difficult to answer, added little information, or had poor correlation with physicians’ assessments (2). Thus, herein we revised the Swedish version of the questionnaire (SWE-SLAQr), building on previous results and we also asked patients for input. Our aim was to get an improved and shorter version, to support clinical work and online registries. The original SLAQ includes 26 items, while SWE-SLAQr includes 20 items.ObjectivesWe compared patients’ assessments of SLE disease activity, as reported in the SWE-SLAQr, with physicians’ assessments using SLE activity measure (SLAM) and SLE disease activity index (SLEDAI-2K). In addition, we evaluated the performance of the symptom items of SWE-SLAQr as compared to the corresponding items in SLAM.MethodsPatients filled out SWE-SLAQr prior to physicians’ assessments. Correlations between SWE-SLAQr-total, sub-scales (Symptom score, Patients global) and SLAM-excluding the 7 laboratory items (SLAM-nolab), SLAM and SLEDAI-2K as well as between the corresponding items in SLAQ and SLAM, were evaluated using Spearman’s ρ.ResultsWe included 101 patients, 85% women, median age 43 (IQR 22) years, disease duration 14 (IQR 15) years. Patients reported more symptoms than recorded by doctors. Correlations between patients’ and physicians’ assessments were for SLAM-nolab: SWE-SLAQr total, ρ=0.674, Symptom score, ρ=0.670, and Patients global, ρ=0.667, as expected the correlations were lower for SLAM: SWE-SLAQr total, ρ=0.472, Symptom score, ρ=0.467, and Patients global, ρ=0.501. No correlations were found between patients’ and physicians’ assessments when using SLEDAI-2K (ρ<0.09 for all). Of symptom items fatigue (ρ=0.741), alopecia (ρ=0.695) and weight loss (0.517) showed highest degree of correlation. Notably, symptoms of dyspnea/pleuritic chest pain had no correlation between patients’ and physicians’ assessments (ρ=0.152, p=0.130).ConclusionWe conclude that SWE-SLAQr performed equally well as SLAQ (2), demonstrating that it can be used to monitor disease activity. We encourage further use of SWE-SLAQr and recommend its implementation in clinical care, we believe it is especially well suited to support digital and telephone contacts. However further attention is needed to evaluate the discrepancy between physicians’ and patients’ evaluation of thoracic pain/symptoms.References[1] Karlson EW, et al. Validation of a Systemic Lupus Activity Questionnaire (SLAQ) for population studies. Lupus. 2003.[2] Pettersson S, et al. A comparison of patients’ and physicians’ assessments of disease activity using the Swedish version of the Systemic Lupus Activity Questionnaire. Scand J Rheumatol. 2017.TableCharacteristics of participantsMedianIQRSWE-SLAQr total (0-37)83.5-13Symptom score (0-19)94-13.5Patients global (0-10)41-7SLAM42-8SLAM nolab31-6S...
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