Systemic Lupus International Collaborating Clinics Frailty Index Predicts Worsening Health-Related Quality of Life, Data From the Almenara Lupus Cohort.

OBJECTIVE

The Systemic Lupus International Collaborating Clinics Frailty Index (SLICC-FI) as a predictor of quality of life (QoL) in patients with systemic lupus erythematosus (SLE) has not been evaluated longitudinally. We estimated the association of SLICC-FI scores with future QoL in our prevalent Latin American Mestizo cohort.

METHODS

Patients from a single-center SLE cohort were included. Health-related QoL was ascertained with the LupusQoL tool, and frailty was ascertained with the SLICC-FI. Generalized estimating equations were performed, using each domain of the LupusQoL as an outcome in the subsequent visit, and the SLICC-FI (as a continuous variable) in the previous visit. Alternative analyses were also conducted including the SLICC-FI as a categorical variable. In both approaches, the multivariable models were adjusted for possible confounders (age at diagnosis, sex, socioeconomic status, ethnicity, Systemic Lupus Erythematosus Disease Activity Index 2000, SLICC/American College of Rheumatology damage index [SDI], disease duration at baseline, prednisone daily dose, antimalarial and immunosuppressive drug treatment, and the same domain of the LupusQoL in the previous visit).

RESULTS

A total of 428 patients and 2,645 visits were included in this study, and they were observed for 4.71 ± 3.52 years. At baseline, the mean ± SD of disease duration, SDI scores, and SLICC-FI scores were 7.2 ± 6.6 years, 1.0 ± 1.3, and 0.17 ± 0.05, respectively. In the main analysis, after adjusting for possible confounders, higher SLICC-FI scores predicted a higher LupusQoL score in the domains of pain, planning, emotional health, and fatigue. In the alternative analyses, after adjustment, the frail and least fit categories were predictive of higher LupusQoL scores in the domain of fatigue, and frailty (SLICC-FI score of >0.21) predicted worse body image compared with least fit (SLICC-FI score 0.03-0.10).

CONCLUSION

Higher SLICC-FI scores predicted worse health-related QoL as measured by higher LupusQoL scores from patients from the Almenara lupus cohort. Our findings reinforce the prognostic value of this tool in patients with SLE.