Health-related Quality Of Life In Patients With Systemic Lupus Erythematosus

Objective:To evaluate the health-related quality of life（HRQOL）of patients with Systemic Lupus Erythematosus（SLE）,explore the impact of SLE on patients’HRQOL,and clarify the relationship between disease activity and HRQOL.And a further comprehensive analysis of the potential factors affecting the HRQOL.Methods:A total of 1568 patients with SLE and 2610 healthy controls were included in this study to explore the impact of SLE on HRQOL,and disease activity scores were recorded.Subgroup analysis was performed according to different demographic characteristics,clinical characteristics,and environmental factors.We then followed up with patients who were regularly reviewed.Finally,1096 patients were enrolled in a follow-up study.The 12 and 24 weeks follow-up studies were designed to assess the relationship between changes in disease activity and HRQOL improvements and to explore further potential factors influencing improvements in HRQOL.The Medical Outcomes Study Short Form-36（SF-36）was used to assess the subjects’HRQOL.The disease activity was evaluated using SLE Disease Activity Index（SLEDAI-2000）.Spearman correlation analysis was used to explore the relationship between disease activity and HRQOL,and between reduced disease activity and improved HRQOL.The influencing factors of HRQOL and improvement of HRQOL were analyzed by Logistic regression.Results:The HRQOL score of SLE patients was significantly lower than that of the control group in all subdimensions and total dimensions of SF-36（P<0.001）,especially in the aspect of Role-Physical（RP）and Role-Emotional（RE）,and the median score of SLE patients was 0.Compared with foreign SLE patients,domestic SLE patients had higher HRQOL scores on the total Mental Component Summary（MCS）but lower scores on the RP and RE dimensions.There was a significant negative correlation between disease activity and HRQOL scores of each subdimension(r^a:-0.079～-0.151,P_adj≤0.002)and the comprehensive dimensions(r^a:-0.153～-0.158,P_adj<0.001)of SF-36,which was fully confirmed by the results of follow-up studies.Namely,the reduction of disease activity was positively correlated with the HRQOL improvements(12 week r^a:0.062～0.223,P_adj<0.05;24 week r^a:0.156～0.263,P_adj<0.001).The main factors affecting the HRQOL of SLE patients are personality,life nervous,disease activity,age,and employment.The main factors affecting the HRQOL improvements at 12 weeks were the decrease in disease activity,new/recurrent,and the occurrence of fever.The main factors affecting the improvement of HRQOL at 24 weeks were reduced disease activity,personality,life nervous,lupus nephritis,and light sensitivity.Conclusion:SLE seriously affects patients’HRQOL,especially in the RP and RE dimensions,and disease activity is negatively correlated with HRQOL.This study also found the impact of personality and life nervous on the HRQOL and HRQOL improvements in patients with SLE for the first time.We also found that disease activity is an essential factor affecting the HRQOL and HRQOL improvement.The results of this study can be used as a basis for the future development of targeted measures and strategies to improve the HRQOL of SLE patients and further research.