生活质量对系统性红斑狼疮患者总体工作效率受损及活动受损的影响：芍药研究
Impact of quality of life on overall work productivity impairment and activity impairment of patients with systemic lupus erythematosus: the PEONY study.
作者信息
Tanaka Yoshiya, Miyazaki Yusuke, Hirata Shintaro, Kusaka Katsuhide, Kosaka Shunpei, Nakatsuka Keisuke, Saito Kazuyoshi, Iwata Shigeru, Yamaguchi Yoshiyuki, Yabe-Wada Toshiki, Fujiwara Masakazu, Arita Yoshifumi, Hoshino Mitsuru, Ozaki Naoko, Yamaoka Kunihiro, Nakayamada Shingo
机构信息
The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
出版信息
Lupus Sci Med. 2025 Jan 19;12(1):e001291. doi: 10.1136/lupus-2024-001291.
OBJECTIVES
Even in a lupus low disease activity state (LLDAS), many patients with SLE continue to face residual symptoms and disease burden. We aimed to evaluate the quality of life, activity impairment and overall work productivity impairment among patients in LLDAS. Residual disease burden was also evaluated for patients in LLDAS.
METHODS
This prospective, cross-sectional study enrolled Japanese outpatients with SLE. Patients completed patient-reported outcome (PRO) questionnaires, including LupusPRO, Work Productivity and Activity Impairment-Lupus, EQ-5D-5L and Health Assessment Questionnaire-Disability Index. Disease activity and organ damage were investigator-assessed. The primary objective was to assess the residual burden in patients in LLDAS and to investigate the association of LupusPRO domains with activity impairment using multivariate regression analysis. Other objectives were to investigate the relationship between overall work productivity impairment or activity impairment and other PRO or disease activity measures.
RESULTS
The analysis set included 205 patients; 93.2% were female, mean (SD) age at index date was 52.5 (14.7) years, mean (SD) duration of morbidity was 167.2 (125.2) months and 164 were in LLDAS. The mean per cent overall work productivity impairment was 22.8% and mean per cent activity impairment was 30.0% for the LLDAS group. Among patients in LLDAS, overall work productivity impairment was significantly associated with the LupusPRO domains Desires-Goals, Body Image and Pain Vitality, and activity impairment was significantly associated with the LupusPRO domains Pain Vitality, Physical Health and Lupus Symptoms.
CONCLUSIONS
Patients with SLE in LLDAS still experience symptoms associated with activity impairment. Work productivity also showed impairments. Improving their quality of life and achieving social remission will require ongoing monitoring of PROs and tailoring treatments to optimise these outcomes.
TRIAL REGISTRATION NUMBER
jRCT1030210647.
目的
即使处于狼疮低疾病活动状态（LLDAS），许多系统性红斑狼疮（SLE）患者仍面临残留症状和疾病负担。我们旨在评估处于LLDAS的患者的生活质量、活动受限情况及总体工作效率受损情况。还对处于LLDAS的患者的残留疾病负担进行了评估。
方法
这项前瞻性横断面研究纳入了日本SLE门诊患者。患者完成了患者报告结局（PRO）问卷，包括狼疮PRO、工作效率和活动受限-狼疮问卷、EQ-5D-5L及健康评估问卷-残疾指数。疾病活动和器官损伤由研究人员评估。主要目的是评估处于LLDAS的患者的残留负担，并使用多变量回归分析研究狼疮PRO各领域与活动受限之间的关联。其他目的是研究总体工作效率受损或活动受限与其他PRO或疾病活动指标之间的关系。
结果
分析集包括205例患者；93.2%为女性，索引日期的平均（标准差）年龄为52.5（14.7）岁，平均（标准差）发病时长为167.2（125.2）个月，164例处于LLDAS。LLDAS组的平均总体工作效率受损百分比为22.8%，平均活动受限百分比为30.0%。在处于LLDAS的患者中，总体工作效率受损与狼疮PRO领域中的愿望-目标、身体形象和疼痛活力显著相关，活动受限与狼疮PRO领域中的疼痛活力、身体健康和狼疮症状显著相关。
结论
处于LLDAS的SLE患者仍经历与活动受限相关的症状。工作效率也出现受损情况。改善他们的生活质量并实现社会缓解将需要持续监测PRO并调整治疗方案以优化这些结果。
试验注册号
jRCT1030210647。
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