The authors declare they have no competing interests.
MB was responsible of conception and design and drafted the manuscript. ÖD participated in the design of the study and performed the statistical analysis. JW has made substantial contributions to conception and design and interpretation of data. CS was responsible for data collection and made substantial contributions in the preparation of the manuscript. All authors have been involved in revising the manuscript critically and have approved the final version.
Systemic lupus erythematosus (SLE) is an autoimmune multi-organ disease, characterized by episodes of disease flares and remissions over time, which may restrain affected patients’ ability to perform daily activities. The purpose of the present study was to characterize variation in activity limitations among well-defined SLE patients, and to describe disease phenotypes, acquired organ damage and their relations to activity limitation and self-reported health, respectively.
The disease phenotypes were organized into 4 different clinical groups and logistic regression analyses were used to identify how an elevated health assessment questionnaire (HAQ) score was related to disease variables such as phenotypes, disease activity and damage accrual. Correlation and multiple linear regression analyses were used to examine the association between each group of variables – background variables, disease variables and self-reported measurements – and the degree of elevated HAQ.
We found a higher proportion of activity limitation in patients with skin and joint involvement compared to others. The presence of activity limitation, as detected by the HAQ instrument, was significantly associated with quality of life (EuroQol–5D) and accrual of organ damage using the Systemic Lupus International Collaborative Clinics/ACR damage index.
The findings highlight the differing requirements of the multi-professional rehabilitation interventions for the various SLE phenotypes in order to optimize the clinical care of the patients.
Gladman DD, Urowitz MB, Rahman P, Ibanez D, Tam LS. Accrual of organ damage over time in patients with systemic lupus erythematosus. J Rheumatol. 2003;30:1955–9. PubMed
Yelin E, Tonner C, Trupin L, Gansky SA, Julian L, Katz P, et al. Longitudinal study of the impact of incident organ manifestations and increased disease activity on work loss among persons with systemic lupus erythematosus. Arthritis Care Res. 2012;64:169–75. CrossRef
Sutcliffe N, Stoll T, Pyke S, Isenberg DA. Functional disability and end organ damage in patients with systemic lupus erythematosus (SLE), SLE and Sjogren's syndrome (SS), and primary SS. J Rheumatol. 1998;25:63–8. PubMed
Wang C, Mayo NE, Fortin PR. The relationship between health related quality of life and disease activity and damage in systemic lupus erythematosus. J Rheumatol. 2001;28:525–32. PubMed
Gilboe IM, Kvien TK, Husby G. Health status in systemic lupus erythematosus compared to rheumatoid arthritis and healthy controls. J Rheumatol. 1999;26:1694–700. PubMed
Milligan SE, Hom DL, Ballou SP, Persse LJ, Svilar GM, Coulton CJ. An assessment of the Health Assessment Questionnaire functional ability index among women with systemic lupus erythematosus. J Rheumatol. 1993;20:972–6. PubMed
Fries JF, Holman HR. Systemic lupus erythematosus: a clinical analysis. Major Probl Intern Med. 1975;6:v–199. PubMed
Gladman DD, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002;29:288–91. PubMed
Scott DL. A simple index to assess disease activity in rheumatoid arthritis. J Rheumatol. 1993;20:582–4. PubMed
Hersh A. Measures of health-related quality of life in pediatric systemic lupus erythematosus: Childhood Health Assessment Questionnaire (C-HAQ), Child Health Questionnaire (CHQ), Pediatric Quality of Life Inventory Generic Core Module (PedsQL-GC), Pediatric Quality of Life Inventory Rheumatology Module (PedsQL-RM), and Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY). Arthritis Care Res. 2011;63 Suppl 11:S446–53. CrossRef
Tollisen A, Sanner H, Flato B, Wahl AK. Quality of life in adults with juvenile-onset dermatomyositis: a case–control study. Arthritis Care Res. 2012;64:1020–7.
Bjork MA, Thyberg IS, Skogh T, Gerdle BU. Hand function and activity limitation according to health assessment questionnaire in patients with rheumatoid arthritis and healthy referents: 5-year followup of predictors of activity limitation (The Swedish TIRA Project). J Rheumatol. 2007;34:296–302. PubMed
Gilboe IM, Kvien TK, Husby G. Disease course in systemic lupus erythematosus: changes in health status, disease activity, and organ damage after 2 years. J Rheumatol. 2001;28:266–74. PubMed
Thyberg I, Skogh T, Hass UA, Gerdle B. Recent-onset rheumatoid arthritis: a 1-year observational study of correlations between health-related quality of life and clinical/laboratory data. J Rehabil Med. 2005;37:159–65. PubMed
Clarke AE, St-Pierre Y, Joseph L, Penrod J, Sibley JT, Haga M, et al. Radiographic damage in rheumatoid arthritis correlates with functional disability but not direct medical costs. J Rheumatol. 2001;28:2416–24. PubMed
Nived O, Jonsen A, Bengtsson AA, Bengtsson C, Sturfelt G. High predictive value of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for survival in systemic lupus erythematosus. J Rheumatol. 2002;29:1398–400. PubMed
Jonsen A, Bengtsson AA, Hjalte F, Petersson IF, Willim M, Nived O: Total cost and cost predictors in systemic lupus erythematosus - 8-years follow-up of a Swedish inception cohort. Lupus 2015. May 8. In press, doi: 10.1177/0961203315584812.
Andrews JS, Trupin L, Schmajuk G, Barton J, Margaretten M, Yazdany J, et al. Muscle Strength, Muscle Mass, and Physical Disability in Women with Systemic Lupus Erythematosus. Arthritis Care Res. 2014;67:120–7. CrossRef
Feld J, Isenberg D. Why and how should we measure disease activity and damage in lupus? Presse Med. 2014;43:e151–6.
- Quality of life and acquired organ damage are intimately related to activity limitations in patients with systemic lupus erythematosus
- BioMed Central
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