Changes in quality of life in the first 5 years of disease in a multicenter cohort of patients with systemic lupus erythematosus.
OBJECTIVE
The Medical Outcomes Study Short Form 36 (SF-36) is recommended to assess quality of life (QOL) in systemic lupus erythematosus (SLE). The aim of the current study was to assess QOL over time in the first 5 years of a multicenter inception cohort of patients with SLE.


METHODS
An inception SLE cohort was assembled according to a standardized protocol between 2000 and 2012. In addition to clinical and laboratory assessments, patients completed the SF-36 at yearly intervals. Only patients who had ≥5 completed QOL questionnaires were included in these analyses. Generalized estimating equation models were run separately for each of the 8 subscales and for the physical and mental component summary scores, adjusting for repeated measures by patients.


RESULTS
A total of 495 patients were included. The mean ± SD disease duration at the first visit was 5.3 ± 4.1 months. The mean ± SD age at enrollment was 35.8 ± 13.2 years. All 8 subscales and the 2 summary scores showed improvement in the first 2 years from enrollment. Between years 2 and 5, none of the subscales or summary scores showed any change. Minimum clinically important improvement was achieved by 35-56% of the patients and was influenced by demographic and disease factors.


CONCLUSIONS
Unlike late-stage lupus, where QOL is stable over time, in patients with early disease, all subscales improve in early followup up to 2 years. Therefore, the SF-36 may be a sensitive outcome measure in early disease in patients with SLE.
Toronto Western Hospital, Toronto, Ontario, Canada.
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Urowitz
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Gladman
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Ibañez
J
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Sanchez-Guerrero
S C
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Bae
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Gordon
P R
PR
Fortin
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Clarke
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Bernatsky
J G
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Hanly
D J
DJ
Wallace
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Isenberg
A
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Rahman
J
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Merrill
E
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Ginzler
G S
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Alarcón
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B
Fessler
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Khamashta
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Steinsson
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Petri
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Dooley
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Bruce
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Manzi
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Sturfelt
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Nived
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Ramsey-Goldman
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Zoma
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Maddison
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Kalunian
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van Vollenhoven
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Aranow
J
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Romero Diaz
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Stoll
D000328:Adult; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult