RESEARCH - Two aspects of the clinical and humanistic burden of SLE: mortality risk and quality of life early in the course of the disease

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Arthritis Rheum. 2008 Mar 27;59(4):458-464

Two aspects of the clinical and humanistic burden of systemic lupus

erythematosus: Mortality risk and quality of life early in the course

of disease.

R Jr, GS, Gilkeson GS.

Medical University of South Carolina, ton.

OBJECTIVE: To evaluate mortality risk and predictors among recently

diagnosed systemic lupus erythematosus (SLE) patients. METHODS: The

vital status of 265 SLE patients and 355 controls enrolled in the

Carolina Lupus Study (median time since diagnosis 13 months) was

determined approximately 5 years after enrollment. We also assessed

the utility of an 8-item quality of life instrument, derived from the

standard 36-item Medical Outcomes Study Short Form 36, as an

additional measure of disease impact. RESULTS: Five years after

diagnosis, 9.7% of patients compared with 0.3% of controls had died (P

< 0.0001). Increased mortality risk was seen among older patients

(adjusted hazard ratio

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1.03, 95% confidence interval [95% CI]

1.01-1.06 per 1-year increment in age) and among men, African

Americans, patients with lupus nephritis, and patients with

anti-double-stranded DNA antibodies (adjusted HR approximately 2.0 for

each of these factors). In addition, patients who did not provide a

blood sample at study enrollment experienced increased mortality risk

(age-, sex-, and race-adjusted HR 3.7, 95% CI 1.5-9.1). Similar

results were seen in analyses limited to time from study enrollment.

Physical component scores of the quality of life measure were 7.7

points lower (P < 0.0001) and mental component scores were 1.8 points

lower (P = 0.07) in patients compared with controls.

CONCLUSION: The mortality risk among SLE patients is significant,

particularly among African Americans, even early in the disease

process and even with currently available treatments. Differences

between cases and controls in health-related quality of life using the

Short Form 8 also demonstrate the multidimensional burden of SLE.

PMID: 18383420

http://www.ncbi.nlm.nih.gov/pubmed/18383420

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