Chaigne Benjamin, Finckh Axel, Alpizar-Rodriguez Deshire, Courvoisier Delphine, Ribi Camillo, Chizzolini Carlo
Clinical Immunology and Allergy, Department of Internal Medicine Specialties, University Hospital and School of Medicine, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
Rheumatology, Department of Internal Medicine Specialties, University Hospital and School of Medicine, Geneva, Switzerland.
Qual Life Res. 2017 Jul;26(7):1767-1775. doi: 10.1007/s11136-017-1534-4. Epub 2017 Mar 11.
This study examined and compared health-related quality of life (QoL) in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).
We included patients from two multicentric cohorts, the Swiss SLE cohort study (SSCS) and the Swiss Clinical Quality Management Program for RA (SCQM-RA). Patients were matched by age, sex and disease duration using the propensity score. Disease activity was assessed by SELENA-SLEDAI in SLE and by DAS-28 in RA. QoL was captured by the short-form 36 (SF-36). The primary outcomes were physical component summary (PCS) and mental component summary (MCS) of the SF-36. Generalized estimating equation models were used to assess evolution over time.
We analyzed 267 SLE patients and 267 matched RA patients. More patients with RA had active disease and more patients with SLE had immunosuppressant therapies at baseline. The median [interquartile range (IQR)] MCS and PCS scores were 45.1 [33.7-52.6] and 45.6 [38.0-53.0] in SLE and 48.8 [37.6-56.7] and 34.7 [26.8-43.0] in RA, respectively (ps < 0.001). Over one year the differences persisted, although PCS and MCS increased in RA (ps < 0.001) but not in SLE in the univariate analysis. The differences in MCS and PCS scores between RA and SLE remained qualitatively similar after adjustment for patient characteristics, treatment, and activity disease.
SLE and RA both affect QoL. Patients with SLE have lower MCS, whereas patients with RA have lower PCS. These differences remained over 1 year of follow up, suggesting fundamental dissimilarities between SLE and RA in their impact on QoL.
本研究对系统性红斑狼疮（SLE）和类风湿关节炎（RA）患者的健康相关生活质量（QoL）进行了检查和比较。
我们纳入了来自两个多中心队列的患者，即瑞士SLE队列研究（SSCS）和瑞士RA临床质量管理项目（SCQM - RA）。使用倾向得分按年龄、性别和病程对患者进行匹配。SLE患者的疾病活动度通过SELENA - SLEDAI评估，RA患者通过DAS - 28评估。生活质量通过简明健康调查问卷（SF - 36）进行评估。主要结局为SF - 36的身体成分总结（PCS）和心理成分总结（MCS）。使用广义估计方程模型评估随时间的变化情况。
我们分析了267例SLE患者和267例匹配的RA患者。在基线时，更多的RA患者患有活动性疾病，更多的SLE患者接受免疫抑制治疗。SLE患者的MCS和PCS得分中位数[四分位间距（IQR）]分别为45.1 [33.7 - 52.6]和45.6 [38.0 - 53.0]，RA患者分别为48.8 [37.6 - 56.7]和34.7 [26.8 - 43.0]（p值均<0.001）。在一年的时间里，差异仍然存在，尽管在单因素分析中RA患者的PCS和MCS有所增加（p值<0.001），而SLE患者没有。在对患者特征、治疗和疾病活动度进行调整后，RA和SLE患者在MCS和PCS得分上的差异在性质上仍然相似。
SLE和RA均会影响生活质量。SLE患者的MCS较低，而RA患者的PCS较低。这些差异在随访的1年中持续存在，表明SLE和RA在对生活质量的影响方面存在根本差异。
