Association of the lupus low disease activity state (LLDAS) with health-related quality of life in a multinational prospective study

Vera Golder, Rangi Kandane-Rathnayake, Alberta Yik-Bun Hoi, Molla Huq, Worawit Louthrenoo, Yuan An, Zhan Guo Li, Shue Fen Luo, Sargunan Sockalingam, Chak Sing Lau, Mo Yin Mok, Aisha Lateef, Kate Franklyn, Susan Morton, Sandra Teresa V Navarra, Leonid Zamora, Yeong Jian Wu, Laniyati Hamijoyo, Madelynn Chan, Sean O'Neill & 3 others Fiona Goldblatt, Mandana Nikpour, Eric Francis Morand

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Abstract

Background: Systemic lupus erythematosus (SLE) is associated with significant impairment of health-related quality of life (HR-QoL). Recently, meeting a definition of a lupus low disease activity state (LLDAS), analogous to low disease activity in rheumatoid arthritis, was preliminarily validated as associated with protection from damage accrual. The LLDAS definition has not been previously evaluated for association with patient-reported outcomes. The objective of this study was to determine whether LLDAS is associated with better HR-QoL, and examine predictors of HR-QoL, in a large multiethnic, multinational cohort of patients with SLE. Methods: HR-QoL was measured using the Medical Outcomes Study 36-item short form health survey (SF-36v2) in a prospective study of 1422 patients. Disease status was measured using the SLE disease activity index (SLEDAI-2 K), physician global assessment (PGA) and LLDAS. Results: Significant differences in SF-36 domain scores were found between patients stratified by ethnic group, education level and damage score, and with the presence of active musculoskeletal or cutaneous manifestations. In multiple linear regression analysis, Asian ethnicity (p < 0.001), a higher level of education (p < 0.001), younger age (p < 0.001) and shorter disease duration (p < 0.01) remained significantly associated with better physical component scores (PCS). Musculoskeletal disease activity (p < 0.001) was negatively associated with PCS, and cutaneous activity (p = 0.04) was negatively associated with mental component scores (MCS). Patients in LLDAS had better PCS (p < 0.001) and MCS (p < 0.001) scores and significantly better scores in multiple individual SF-36 domain scores. Disease damage was associated with worse PCS (p < 0.001), but not MCS scores. Conclusions: Ethnicity, education, disease damage and specific organ involvement impacts HR-QoL in SLE. Attainment of LLDAS is associated with better HR-QoL.

Original languageEnglish
Article number62
Number of pages11
JournalArthritis Research and Therapy
Volume19
Issue number1
DOIs
Publication statusPublished - 20 Mar 2017

Keywords

  • Health-related quality of life
  • Low disease activity
  • Patient-reported outcomes
  • Systemic lupus erythematosus
  • Treatment target

Cite this

Golder, Vera ; Kandane-Rathnayake, Rangi ; Hoi, Alberta Yik-Bun ; Huq, Molla ; Louthrenoo, Worawit ; An, Yuan ; Li, Zhan Guo ; Luo, Shue Fen ; Sockalingam, Sargunan ; Lau, Chak Sing ; Mok, Mo Yin ; Lateef, Aisha ; Franklyn, Kate ; Morton, Susan ; Navarra, Sandra Teresa V ; Zamora, Leonid ; Wu, Yeong Jian ; Hamijoyo, Laniyati ; Chan, Madelynn ; O'Neill, Sean ; Goldblatt, Fiona ; Nikpour, Mandana ; Morand, Eric Francis. / Association of the lupus low disease activity state (LLDAS) with health-related quality of life in a multinational prospective study. In: Arthritis Research and Therapy. 2017 ; Vol. 19, No. 1.
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title = "Association of the lupus low disease activity state (LLDAS) with health-related quality of life in a multinational prospective study",
abstract = "Background: Systemic lupus erythematosus (SLE) is associated with significant impairment of health-related quality of life (HR-QoL). Recently, meeting a definition of a lupus low disease activity state (LLDAS), analogous to low disease activity in rheumatoid arthritis, was preliminarily validated as associated with protection from damage accrual. The LLDAS definition has not been previously evaluated for association with patient-reported outcomes. The objective of this study was to determine whether LLDAS is associated with better HR-QoL, and examine predictors of HR-QoL, in a large multiethnic, multinational cohort of patients with SLE. Methods: HR-QoL was measured using the Medical Outcomes Study 36-item short form health survey (SF-36v2) in a prospective study of 1422 patients. Disease status was measured using the SLE disease activity index (SLEDAI-2 K), physician global assessment (PGA) and LLDAS. Results: Significant differences in SF-36 domain scores were found between patients stratified by ethnic group, education level and damage score, and with the presence of active musculoskeletal or cutaneous manifestations. In multiple linear regression analysis, Asian ethnicity (p < 0.001), a higher level of education (p < 0.001), younger age (p < 0.001) and shorter disease duration (p < 0.01) remained significantly associated with better physical component scores (PCS). Musculoskeletal disease activity (p < 0.001) was negatively associated with PCS, and cutaneous activity (p = 0.04) was negatively associated with mental component scores (MCS). Patients in LLDAS had better PCS (p < 0.001) and MCS (p < 0.001) scores and significantly better scores in multiple individual SF-36 domain scores. Disease damage was associated with worse PCS (p < 0.001), but not MCS scores. Conclusions: Ethnicity, education, disease damage and specific organ involvement impacts HR-QoL in SLE. Attainment of LLDAS is associated with better HR-QoL.",
keywords = "Health-related quality of life, Low disease activity, Patient-reported outcomes, Systemic lupus erythematosus, Treatment target",
author = "Vera Golder and Rangi Kandane-Rathnayake and Hoi, {Alberta Yik-Bun} and Molla Huq and Worawit Louthrenoo and Yuan An and Li, {Zhan Guo} and Luo, {Shue Fen} and Sargunan Sockalingam and Lau, {Chak Sing} and Mok, {Mo Yin} and Aisha Lateef and Kate Franklyn and Susan Morton and Navarra, {Sandra Teresa V} and Leonid Zamora and Wu, {Yeong Jian} and Laniyati Hamijoyo and Madelynn Chan and Sean O'Neill and Fiona Goldblatt and Mandana Nikpour and Morand, {Eric Francis}",
year = "2017",
month = "3",
day = "20",
doi = "10.1186/s13075-017-1256-6",
language = "English",
volume = "19",
journal = "Arthritis Research and Therapy",
issn = "1478-6354",
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Golder, V, Kandane-Rathnayake, R, Hoi, AY-B, Huq, M, Louthrenoo, W, An, Y, Li, ZG, Luo, SF, Sockalingam, S, Lau, CS, Mok, MY, Lateef, A, Franklyn, K, Morton, S, Navarra, STV, Zamora, L, Wu, YJ, Hamijoyo, L, Chan, M, O'Neill, S, Goldblatt, F, Nikpour, M & Morand, EF 2017, 'Association of the lupus low disease activity state (LLDAS) with health-related quality of life in a multinational prospective study', Arthritis Research and Therapy, vol. 19, no. 1, 62. https://doi.org/10.1186/s13075-017-1256-6

Association of the lupus low disease activity state (LLDAS) with health-related quality of life in a multinational prospective study. / Golder, Vera; Kandane-Rathnayake, Rangi; Hoi, Alberta Yik-Bun; Huq, Molla; Louthrenoo, Worawit; An, Yuan; Li, Zhan Guo; Luo, Shue Fen; Sockalingam, Sargunan; Lau, Chak Sing; Mok, Mo Yin; Lateef, Aisha; Franklyn, Kate; Morton, Susan; Navarra, Sandra Teresa V; Zamora, Leonid; Wu, Yeong Jian; Hamijoyo, Laniyati; Chan, Madelynn; O'Neill, Sean; Goldblatt, Fiona; Nikpour, Mandana; Morand, Eric Francis.

In: Arthritis Research and Therapy, Vol. 19, No. 1, 62, 20.03.2017.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Association of the lupus low disease activity state (LLDAS) with health-related quality of life in a multinational prospective study

AU - Golder, Vera

AU - Kandane-Rathnayake, Rangi

AU - Hoi, Alberta Yik-Bun

AU - Huq, Molla

AU - Louthrenoo, Worawit

AU - An, Yuan

AU - Li, Zhan Guo

AU - Luo, Shue Fen

AU - Sockalingam, Sargunan

AU - Lau, Chak Sing

AU - Mok, Mo Yin

AU - Lateef, Aisha

AU - Franklyn, Kate

AU - Morton, Susan

AU - Navarra, Sandra Teresa V

AU - Zamora, Leonid

AU - Wu, Yeong Jian

AU - Hamijoyo, Laniyati

AU - Chan, Madelynn

AU - O'Neill, Sean

AU - Goldblatt, Fiona

AU - Nikpour, Mandana

AU - Morand, Eric Francis

PY - 2017/3/20

Y1 - 2017/3/20

N2 - Background: Systemic lupus erythematosus (SLE) is associated with significant impairment of health-related quality of life (HR-QoL). Recently, meeting a definition of a lupus low disease activity state (LLDAS), analogous to low disease activity in rheumatoid arthritis, was preliminarily validated as associated with protection from damage accrual. The LLDAS definition has not been previously evaluated for association with patient-reported outcomes. The objective of this study was to determine whether LLDAS is associated with better HR-QoL, and examine predictors of HR-QoL, in a large multiethnic, multinational cohort of patients with SLE. Methods: HR-QoL was measured using the Medical Outcomes Study 36-item short form health survey (SF-36v2) in a prospective study of 1422 patients. Disease status was measured using the SLE disease activity index (SLEDAI-2 K), physician global assessment (PGA) and LLDAS. Results: Significant differences in SF-36 domain scores were found between patients stratified by ethnic group, education level and damage score, and with the presence of active musculoskeletal or cutaneous manifestations. In multiple linear regression analysis, Asian ethnicity (p < 0.001), a higher level of education (p < 0.001), younger age (p < 0.001) and shorter disease duration (p < 0.01) remained significantly associated with better physical component scores (PCS). Musculoskeletal disease activity (p < 0.001) was negatively associated with PCS, and cutaneous activity (p = 0.04) was negatively associated with mental component scores (MCS). Patients in LLDAS had better PCS (p < 0.001) and MCS (p < 0.001) scores and significantly better scores in multiple individual SF-36 domain scores. Disease damage was associated with worse PCS (p < 0.001), but not MCS scores. Conclusions: Ethnicity, education, disease damage and specific organ involvement impacts HR-QoL in SLE. Attainment of LLDAS is associated with better HR-QoL.

AB - Background: Systemic lupus erythematosus (SLE) is associated with significant impairment of health-related quality of life (HR-QoL). Recently, meeting a definition of a lupus low disease activity state (LLDAS), analogous to low disease activity in rheumatoid arthritis, was preliminarily validated as associated with protection from damage accrual. The LLDAS definition has not been previously evaluated for association with patient-reported outcomes. The objective of this study was to determine whether LLDAS is associated with better HR-QoL, and examine predictors of HR-QoL, in a large multiethnic, multinational cohort of patients with SLE. Methods: HR-QoL was measured using the Medical Outcomes Study 36-item short form health survey (SF-36v2) in a prospective study of 1422 patients. Disease status was measured using the SLE disease activity index (SLEDAI-2 K), physician global assessment (PGA) and LLDAS. Results: Significant differences in SF-36 domain scores were found between patients stratified by ethnic group, education level and damage score, and with the presence of active musculoskeletal or cutaneous manifestations. In multiple linear regression analysis, Asian ethnicity (p < 0.001), a higher level of education (p < 0.001), younger age (p < 0.001) and shorter disease duration (p < 0.01) remained significantly associated with better physical component scores (PCS). Musculoskeletal disease activity (p < 0.001) was negatively associated with PCS, and cutaneous activity (p = 0.04) was negatively associated with mental component scores (MCS). Patients in LLDAS had better PCS (p < 0.001) and MCS (p < 0.001) scores and significantly better scores in multiple individual SF-36 domain scores. Disease damage was associated with worse PCS (p < 0.001), but not MCS scores. Conclusions: Ethnicity, education, disease damage and specific organ involvement impacts HR-QoL in SLE. Attainment of LLDAS is associated with better HR-QoL.

KW - Health-related quality of life

KW - Low disease activity

KW - Patient-reported outcomes

KW - Systemic lupus erythematosus

KW - Treatment target

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