Rheumatology and therapy · 2026
Longitudinal Trajectories and Predictors of Health-Related Quality of Life in Systemic Lupus Erythematosus: A 2-Year Longitudinal Cohort Study.
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Hsu Wan-Yun, Lai Ching-Yi, Tsai Li-Yun, Chen I-Chieh, Chen Jun-Peng, Chen Kai-Ting, Kao Chung-Mao, Chen Yen-Ju, Tang Kuo-Tung, Hung Wei-Ting, Huang Wen-Nan, Chen Yi-Ming
Аннотация
INTRODUCTION: Health-related quality of life (HRQoL) is a critical patient-reported outcome in systemic lupus erythematosus (SLE). We aimed to evaluate longitudinal trajectories of HRQoL and identify associated clinical and demographic determinants.
METHODS: This longitudinal cohort study included 1005 patients with SLE from the Asia Pacific Lupus Collaboration. HRQoL was assessed using the Short Form-36 (SF-36) at baseline, 12, and 24 months. Disease activity and organ damage were recorded using validated composite indices (SLEDAI-2 K and SLICC damage index). Generalized estimating equations (GEE) analyzed longitudinal trajectories of Physical Component Summary (PCS) and Mental Component Summary (MCS) scores.
RESULTS: Among 915 women (91.0%) with median age 35.2 years, both PCS and MCS scores remained stable over 24 months (PCS: p = 0.822; MCS: p = 0.819). Age ≥ 50 years was associated with lower PCS (β = - 5.80, p = 3.85 × 10 -9) but higher MCS (β = 2.09, p = 0.032). Male sex predicted higher MCS (β = 3.50, p = 2.70 × 10-5). Higher SLEDAI-2 K was associated with lower PCS and MCS (both p < 0.05). SLICC damage index negatively affected PCS (β = - 1.87, p < 0.001) and MCS (β = - 0.75, p = 0.006). Musculoskeletal and cardiovascular damage had the strongest associations with reduced PCS, while no organ-specific damage remained significantly associated with MCS after adjustment.
CONCLUSIONS: HRQoL in SLE remained stable over 2 years. Disease activity and cumulative organ damage were the primary determinants. Organ-specific damage differentially influenced physical but not mental health domains, underscoring the need for domain-tailored assessment and management strategies.
METHODS: This longitudinal cohort study included 1005 patients with SLE from the Asia Pacific Lupus Collaboration. HRQoL was assessed using the Short Form-36 (SF-36) at baseline, 12, and 24 months. Disease activity and organ damage were recorded using validated composite indices (SLEDAI-2 K and SLICC damage index). Generalized estimating equations (GEE) analyzed longitudinal trajectories of Physical Component Summary (PCS) and Mental Component Summary (MCS) scores.
RESULTS: Among 915 women (91.0%) with median age 35.2 years, both PCS and MCS scores remained stable over 24 months (PCS: p = 0.822; MCS: p = 0.819). Age ≥ 50 years was associated with lower PCS (β = - 5.80, p = 3.85 × 10 -9) but higher MCS (β = 2.09, p = 0.032). Male sex predicted higher MCS (β = 3.50, p = 2.70 × 10-5). Higher SLEDAI-2 K was associated with lower PCS and MCS (both p < 0.05). SLICC damage index negatively affected PCS (β = - 1.87, p < 0.001) and MCS (β = - 0.75, p = 0.006). Musculoskeletal and cardiovascular damage had the strongest associations with reduced PCS, while no organ-specific damage remained significantly associated with MCS after adjustment.
CONCLUSIONS: HRQoL in SLE remained stable over 2 years. Disease activity and cumulative organ damage were the primary determinants. Organ-specific damage differentially influenced physical but not mental health domains, underscoring the need for domain-tailored assessment and management strategies.