Correlation between irreversible organ damage and the quality of life of patients with systemic lupus erythematosus: The Kyoto Lupus Cohort survey

Abstract

Objectives It is important to clarify the relationship between irreversible organ damage and the quality of life (QOL) by considering the unique factors of patients with systemic lupus erythematosus (SLE). We aimed to clarify their correlation using SLE-specific QOL assessment tools. We also aimed to identify which type of organ damage is adversely correlated with the QOL. Methods We conducted a questionnaire-based survey of outpatients with SLE at Kyoto University Hospital and evaluated irreversible organ damage using the SLICC/ACR damage index (SDI). LupusPRO and the SLE symptom checklist (SSC) were employed as SLE-specific QOL tools, and the SF-36v2 was used as a conventional QOL tool. Multiple linear regression analyses were performed to examine the correlations between the total SDI score and each QOL score, and between each SDI item/system score and each QOL score. Results We analyzed the data of 265 patients. The total SDI score was significantly correlated with physical (PCS) and role/social component summary (RCS) of the SF-36v2, health-related QOL (HRQOL) of LupusPRO, and SSC ( p < 0.001). Among the SDI items, atrophy/weakness and osteoporosis with fracture/vertebral collapse were negatively correlated with PCS (β = −0.40, p < 0.001/β = −0.28, p < 0.001), RCS (β = −0.30, p < 0.001/β = −0.35, p < 0.001), and HRQOL (β = −0.34, p < 0.001/β = −0.31, p < 0.001), respectively. Among the SDI systems, musculoskeletal damage had higher negative correlations with PCS (β = −0.51, p < 0.001), RCS (β = −0.29, p < 0.001), and HRQOL (β = −0.40, p < 0.001). Conclusion We demonstrated the QOL of patients with SLE is negatively correlated with irreversible organ damage. We also revealed musculoskeletal damage is adversely correlated with the health-related QOL, especially the physical and role/social QOL.

Patient-reported outcomes and healthcare resource utilization in systemic lupus erythematosus: impact of disease activity

“…Irreversible damage (as assessed by Systemic Lupus International Collaborating Clinics [SLICC] score/ American College of Rheumatology [ACR] damage index) is widely recognized to be associated with poorer quality of life, with the type of organ involvement potentially affecting disability and work ability differently [ 45 , 46 ]. For example, a past study found that organ damage, specifically musculoskeletal damage, was negatively correlated with HRQoL, particularly the physical and social aspects [ 46 ]. A second study reported similar findings, with skin and joint involvement leading to a higher proportion of the patients experiencing activity impairment [ 45 ], indicating that patients with this type of organ damage should be examined and monitored closely in clinical practice [ 46 ].…”

Patient-reported outcomes and healthcare resource utilization in systemic lupus erythematosus: Impact of disease activity

“…[SLICC] score/ American College of Rheumatology [ACR] damage index) is widely recognized to be associated with poorer quality of life, with the type of organ involvement potentially affecting disability and work ability differently [45,46]. For example, a past study found that organ damage, specifically musculoskeletal damage, was negatively correlated with HRQoL, particularly the physical and social aspects [46].…”

“…[SLICC] score/ American College of Rheumatology [ACR] damage index) is widely recognized to be associated with poorer quality of life, with the type of organ involvement potentially affecting disability and work ability differently [45,46]. For example, a past study found that organ damage, specifically musculoskeletal damage, was negatively correlated with HRQoL, particularly the physical and social aspects [46]. A second study reported similar findings, with skin and joint involvement leading to a higher proportion of the patients experiencing activity impairment [45], indicating that patients with this type of organ damage should be examined and monitored closely in clinical practice [46].…”

Predictors of Organ Damage in Systemic Lupus Erythematosus in the Asia Pacific Region: A Systematic Review

“…Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease with great heterogeneity in its clinical course and treatment response. In addition to minimization of flares and optimizing health‐related quality of life, one of the major treatment goals in SLE is prevention of organ damage, as this predicts mortality and poorer quality of life 1,2 . The Systemic Lupus International Collaborating Clinic/American College of Rheumatology (ACR) Damage Index (SDI) is a validated instrument that measures organ damage present for at least 6 months as a consequence of the disease itself or treatment 3 .…”

“…In addition to minimization of flares and optimizing health-related quality of life, one of the major treatment goals in SLE is prevention of organ damage, as this predicts mortality and poorer quality of life. 1,2 The Systemic Lupus International Collaborating Clinic/American College of Rheumatology (ACR) Damage Index (SDI) is a validated instrument that measures organ damage present for at least 6 months as a consequence of the disease itself or treatment. 3 SDI evaluates damage across 12 organ systems, and the total SDI score represents the burden of damage.…”