Quality of life and acquired organ damage are intimately related to activity limitations in patients with systemic lupus erythematosus.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Rehabilitation Center and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. mathilda.bjork@liu.se.|Department of Rehabilitation, School of Health Sciences, Jönköping University, Jönköping, Sweden. mathilda.bjork@liu.se.
Mathilda
M
Björk
Swedish Institute for Disability Research, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden. orjan.dahlstrom@liu.se.
Örjan
Ö
Dahlström
Rheumatology/AIR, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. jonas.wettero@liu.se.
Jonas
J
Wetterö
Rheumatology/AIR, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. christopher.sjowall@liu.se.
Christopher
C
Sjöwall
D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult