Unit of Allergology, Clinical Immunology and Rheumatology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
Division of Rheumatology, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
Lupus. 2019 Dec;28(14):1705-1711. doi: 10.1177/0961203319884651. Epub 2019 Nov 10.
To evaluate the impact of duration of remission on the health-related quality of life (HRQoL) of patients with systemic lupus erythematosus (SLE).
We conducted a 5-year retrospective study on two Italian cohorts. Remission was defined as a continuative period of no clinical disease activity, according to the Systemic Lupus Erythematosus Disease Activity Index 2 K, and a permitted maximum prednisone dose of 5 mg/day. HRQoL was measured using the 36-Item Short-Form Health Survey (SF36) during the last visit.
We enrolled 136 female SLE patients. During observation, 15 (11%) patients had been in remission for ≥1 and <2 years, 15 (11%) for ≥2 and <3 years, 19 (14%) for ≥3 and <4 years, 9 (7%) for ≥4 and <5 years, and 53 (39%) had been in prolonged remission for ≥5 years. In the multivariate model, considering depression and fatigue as covariates, patients in prolonged remission showed significantly better scores in the physical functioning ( = 0.039), role physical (0.029), bodily pain ( = 0.0057), general health ( = 0.0033) and social functioning ( = 0.0085) components of the SF36, compared with those in remission <5 years or unremitted. Subsequent mediation analyses found that these effects were partly influenced by depression.
Lupus remission could improve the HRQoL of SLE patients, particularly when associated with appropriate management of depression and fatigue.
评估缓解持续时间对系统性红斑狼疮（SLE）患者健康相关生活质量（HRQoL）的影响。
我们对两个意大利队列进行了一项为期 5 年的回顾性研究。缓解定义为根据系统性红斑狼疮疾病活动指数 2K 持续无临床疾病活动期，且允许最大泼尼松剂量为 5mg/天。HRQoL 在最后一次就诊时使用 36 项简短健康调查（SF36）进行测量。
我们纳入了 136 名女性 SLE 患者。在观察期间，15 名（11%）患者缓解持续时间≥1 年且<2 年，15 名（11%）患者缓解持续时间≥2 年且<3 年，19 名（14%）患者缓解持续时间≥3 年且<4 年，9 名（7%）患者缓解持续时间≥4 年且<5 年，53 名（39%）患者缓解持续时间≥5 年。在多变量模型中，考虑到抑郁和疲劳作为协变量，缓解持续时间较长的患者在 SF36 的身体功能（ = 0.039）、身体角色（0.029）、躯体疼痛（ = 0.0057）、一般健康（ = 0.0033）和社会功能（ = 0.0085）方面的评分显著更好，与缓解持续时间<5 年或未缓解的患者相比。随后的中介分析发现，这些影响部分受到抑郁的影响。
狼疮缓解可以改善 SLE 患者的 HRQoL，尤其是在与适当管理抑郁和疲劳相结合时。
