Disease course in systemic lupus erythematosus: changes in health status, disease activity, and organ damage after 2 years.
OBJECTIVE
To examine changes in health status, disease activity, and organ damage after 2 years and to study possible disease variables predicting change in health status, disease activity, and organ damage at followup in systemic lupus erythematosus (SLE). Second, to compare changes in health status in patients with SLE to that of matched patients with rheumatoid arthritis (RA) and matched healthy controls.


METHODS
A 2 year longitudinal observational study, measuring health status (Short-Form 36. visual analog scale for pain and fatigue, modified Health Assessment Questionnaire, patient global assessment of disease activity), disease activity, and organ damage in 87 patients with SLE. Health status measures in SLE were compared to 65 matched RA patients selected from the Oslo RA register and to 77 matched healthy controls from the population register.


RESULTS
On a group level the SLE patients showed stable health status measures and disease activity scores 2 years after baseline, but organ damage scores increased significantly. Increase in organ damage was significantly and independently predicted by baseline scores of disease activity and organ damage, health status, and disease activity by the respective baseline scores. Changes in health status measures over 2 years were similar in SLE, RA, and healthy controls.


CONCLUSIONS
Our 2 year longitudinal observational SLE study showed a stable course of health status and disease activity, whereas organ damage increased. Disease activity and organ damage at baseline predicted the latter. Our results indicate the value of careful monitoring of disease activity over time in SLE and individually tailored treatment guided by the predictors of course and outcome.
Oslo City Department of Rheumatology, Diakonhjemmet Hospital, and the Centre for Rheumatic Diseases, The National Hospital, Oslo, Norway.
I M
IM
Gilboe
T K
TK
Kvien
G
G
Husby
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D005221:Fatigue / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000473:pathology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000473:pathology / Q000503:physiopathology; D010147:Pain Measurement; D011237:Predictive Value of Tests; D012737:Sex Factors; D013997:Time Factors