Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85, Linköping, Sweden.
Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden.
Clin Rheumatol. 2022 May;41(5):1561-1568. doi: 10.1007/s10067-021-05982-3. Epub 2021 Nov 27.
The onset of rheumatic disease affects each patient differently and may impact quality of life with progression. We investigated the relationship between patient-reported outcome measure (PROM) scores and organ damage in patients with recent-onset systemic lupus erythematosus (SLE) and those with early rheumatoid arthritis (RA). Patients with recent-onset SLE without prior organ damage from the Clinical Lupus Register in Northeastern Gothia and patients with early RA from the observational 2nd Timely Interventions in Early RA study, Sweden, were included. Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index (SDI) was used to assess organ damage. PROM (visual analog scale [VAS]: pain, fatigue, well-being, Health Assessment Questionnaire, and EQ-5D-3L) scores were captured at months 0, 6, 12, 24, 36, 48, and 60 after diagnosis. Statistical tests included Pearson correlation coefficients and t-tests. Forty-one patients with recent-onset SLE and 522 with early RA were included. Numerical differences were seen in age and sex. PROMs were worse for patients with RA versus SLE but improved by month 6 following diagnosis, while SLE PROMs remained stable. The incidence of organ damage in SLE was 13.6 per 100 patient-years. SDI significantly correlated with EQ-5D-3L (- 0.48, P = 0.003), VAS fatigue (0.44, P = 0.009), and well-being (0.41, P = 0.01) at month 24. As illustrated, the complexity of disease burden in patients with SLE is clear and may result from disease-related multiorgan system effects and slower symptom resolution compared with RA. This underscores the need for improved multiprofessional interventions to manage all aspects of SLE. Key Points • We observed an evident discrepancy in patient-reported outcome measures (PROMs) between patients with recent-onset SLE and early RA. • Despite differences in PROMs between patients with recent-onset SLE and early RA, both groups had prominent self-reported disability during the study period. • PROM scores for patients with RA were generally worse than those with SLE but improved by month 6, whereas PROM scores for patients with SLE remained stable over time. • Our findings underline the need of new therapeutic options and interventions for SLE disease management, including pharmacologic and multiprofessional aspects.
风湿性疾病的发病影响每个患者的情况各不相同，并可能随着病情的进展而影响生活质量。我们研究了近期发病的系统性红斑狼疮（SLE）患者和早期类风湿关节炎（RA）患者的患者报告结局测量（PROM）评分与器官损伤之间的关系。纳入了来自瑞典的东北哥特地区临床狼疮登记处的无既往器官损伤的近期发病 SLE 患者和来自及时干预早期 RA 研究的早期 RA 患者。使用系统性红斑狼疮国际合作临床/美国风湿病学会损伤指数（SDI）评估器官损伤。在诊断后 0、6、12、24、36、48 和 60 个月时采集 PROM（视觉模拟量表[VAS]：疼痛、疲劳、健康状况、健康评估问卷和 EQ-5D-3L）评分。统计检验包括 Pearson 相关系数和 t 检验。纳入了 41 例近期发病的 SLE 患者和 522 例早期 RA 患者。年龄和性别方面存在数值差异。与 RA 患者相比，SLE 患者的 PROM 更差，但在诊断后 6 个月时得到改善，而 SLE 的 PROM 保持稳定。SLE 的器官损伤发生率为每 100 患者年 13.6 例。在第 24 个月时，SDI 与 EQ-5D-3L（-0.48，P=0.003）、VAS 疲劳（0.44，P=0.009）和健康状况（0.41，P=0.01）显著相关。如图所示，SLE 患者的疾病负担复杂性显而易见，这可能是由于疾病相关的多器官系统效应以及与 RA 相比症状缓解较慢所致。这突显了需要改进多专业干预措施来管理 SLE 的各个方面。主要观点 • 我们观察到近期发病的 SLE 患者和早期 RA 患者的患者报告结局测量（PROM）之间存在明显差异。 • 尽管近期发病的 SLE 患者和早期 RA 患者的 PROM 存在差异，但在研究期间，两组患者均有明显的自我报告残疾。 • RA 患者的 PROM 评分通常比 SLE 患者差，但在 6 个月时得到改善，而 SLE 患者的 PROM 评分随时间保持稳定。 • 我们的研究结果强调了需要为 SLE 疾病管理制定新的治疗选择和干预措施，包括药理学和多专业方面。
