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缓解时间和低疾病活动状态(LDAS)与系统性红斑狼疮患者的生活质量改善相关:来自 LUMINA(LXXIX)的结果,一个多民族、多中心的美国队列研究。

Time in remission and low disease activity state (LDAS) are associated with a better quality of life in patients with systemic lupus erythematosus: results from LUMINA (LXXIX), a multiethnic, multicentre US cohort.

机构信息

Servicio de Reumatología, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru.

School of Medicine, Universidad Científica del Sur, Lima, Peru.

出版信息

RMD Open. 2019 May 23;5(1):e000955. doi: 10.1136/rmdopen-2019-000955. eCollection 2019.

Abstract

AIMS

To determine whether the proportion of time systemic lupus erythematosus patients achieve remission/low disease activity state (LDAS) is associated with a better quality of life (QoL).

PATIENTS AND METHODS

Patients from a well-established multiethnic, multicentre US cohort were included: remission: Systemic Lupus Activity Measure (SLAM) score=0, prednisone≤5 mg/day and no immunosuppressants); LDAS not in remission, SLAM score≤3, prednisone≤7.5 mg/day, no immunosuppressants; the combined proportion of time patients were in these states was the independent variable. The endpoints were the Physical and Mental Components Summary measures (PCS and MCS, respectively) and the individual subscales of the Short Form (SF)-36 at the last visit. Linear regression was used to estimate the association between the proportion of follow-up time in remission/LDAS and the SF-36 measures with and without adjustment for possible confounders.

RESULTS

Four hundred and eighty-three patients were included. The per cent of time on remission/LDAS was associated with better QoL after adjusting for potential confounders; for the PCS the parameter estimate was 9.47 (p<0.0001), for the MCS 5.89 (p=0.0027), and for the subscales they ranged between 7.51 (p=0.0495) for mental health and 31.79 (p<0.0001) for role physical.

CONCLUSIONS

The per cent of time lupus patients stay on remission/LDAS is associated with a better QoL as measured by SF-36.

摘要

目的

确定系统性红斑狼疮患者达到缓解/低疾病活动状态(LDAS)的时间比例是否与更好的生活质量(QoL)相关。

患者和方法

本研究纳入了来自一个成熟的多民族、多中心美国队列的患者:缓解:系统性红斑狼疮活动度评分(SLAM)=0,泼尼松≤5mg/天且无免疫抑制剂;未缓解的 LDAS,SLAM 评分≤3,泼尼松≤7.5mg/天,无免疫抑制剂;患者处于这些状态的时间比例是独立变量。终点是最后一次就诊时的身体和精神成分综合测量(PCS 和 MCS)以及简短表格(SF)-36 的各个子量表。线性回归用于估计在缓解/LDAS 随访时间比例与 SF-36 测量值之间的关联,调整了可能的混杂因素。

结果

共纳入 483 例患者。调整潜在混杂因素后,缓解/LDAS 的时间比例与更好的 QoL 相关;对于 PCS,参数估计值为 9.47(p<0.0001),对于 MCS 为 5.89(p=0.0027),对于子量表,它们的范围在心理健康的 7.51(p=0.0495)和身体角色的 31.79(p<0.0001)之间。

结论

狼疮患者处于缓解/LDAS 的时间比例与 SF-36 测量的 QoL 更好相关。

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