The effect of therapies on the quality of life of patients with systemic lupus erythematosus: a meta-analysis of randomized trials

Abstract

Introduction: Systemic lupus erythematosus (SLE) is a multi-systemic, chronic inflammatory disease of autoimmune nature, which can impair performance in daily life activities, causing to a compromised quality of life. Thus, the aim of this study was to evaluate the effect of therapies, such as physical activity, cognitive behavioral therapy, pharmacological treatment and phytotherapy in the quality of life of patients with systemic lupus erythematosus. Materials and methods: A systematic review with a meta-analysis of randomized clinical trials was conducted by searching the PubMed database, including studies comparing patients who participated in cognitive therapy, physical activity, pharmacological treatment or phytotherapeutic treatment. Results: Of the seven studies included in this meta-analysis, a significant difference was observed in the quality of life of patients with lupus who participated in the intervention groups compared to the control groups (− 10.27 95% CI: − 15, 77 at − 4.77, p = 0.0003, I2 = 0%). Conclusion: Interventions improve the Quality of life of patients with SLE. However, the methodological quality of the included articles and the sizes of the samples for being small propose that new randomized clinical trials be performed.

Determinants of sexual function in male patients with systemic lupus erythematosus

“…29 Another possible intervention is cognitivebehavioural therapy as it has been shown to improve physical, social and mental function, while also lowering levels of depression and anxiety in SLE patients. 30,31 Patient-oriented research is essential to design new strategies for the management of lupus patients. 32 Some of the limitations of this study include its crosssectional design, which minimizes the causal inferences that can be made regarding psychological variables and the perception of sexual function.…”

“…29 Another possible intervention is cognitive-behavioural therapy as it has been shown to improve physical, social and mental function, while also lowering levels of depression and anxiety in SLE patients. 30,31 Patient-oriented research is essential to design new strategies for the management of lupus patients. 32…”

Fatores influentes da qualidade de vida em pessoas com lúpus eritematoso sistêmico

“…Mesmo que as taxas de sobrevida de indivíduos com LES venham apresentando aumento significativo nos últimos anos, (18) isto não necessariamente tem impactado na QVRS, (13,16,19,20) pois a mesma é influenciada por manifestações da doença decorrentes do processo de adoecimento. Destarte, o LES é uma doença incurável de evolução não uniforme, sendo comum a existência de períodos de exacerbação e remissão, (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) levando ao comprometimento da vida cotidiana, a recorrentes internações hospitalares e, consequentemente, a uma baixa QVRS.…”

“…(7,8) Além dos sintomas específicos, a presença frequente da dor tem sido relacionada aos níveis de fadiga, ansiedade e depressão, (8) que associados a outros sintomas acabam por comprometer o cotidiano e a qualidade de vida relacionada à saúde (QVRS). (9) Além disso, o adoecimento por LES pode desenvolver complicações como a doença renal crônica, dano vascular, aterosclerose, dentre outras. (10) Marcadas por limitações físicas e psicológicas significativas, que também impactam na condição física, psíquica e social do individuo e consequentemente em sua QVRS.…”

A prescription for exercise in systemic lupus erythematosus

“…In SLE specifically, despite the paucity of data, mindful-based interventions, such as cognitive behavioral therapy, have been shown to improve pain, 46 physical functioning, 46 stress, 47 anxiety, 47,48 and quality of life. 49–51 Moreover, aerobic exercise has been shown to improve fatigue, 26,52–57 depression, 52 and anxiety 57 in SLE. With increasing evidence emphasizing the importance of reduction in stress in addition to the multidimensional benefits of exercise, it stands to reason that regular physical activity be incorporated into standard daily clinical practice.…”