https://orcid.org/0000-0002-3120-1273
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Yoko Nose, Akira Onishi, Keisuke Nishimura, Yuzuru Yamamoto, Ken-ei Sada, Kunihiro Ichinose, Ryusuke Yoshimi, Shigeru Ohno, Ryo Yanai, Hiroshi Kajiyama, Shuzo Sato, Yasuhiro Shimojima, Michio Fujiwara, Takashi Kida, Yoshia Miyawaki, Yusuke Matsuo, Hideaki Tsuji, Akio Morinobu, Jun Saegusa, Predictive validity of Lupus Patient-Reported Outcome for damage accrual in patients with systemic lupus erythematosus: the LUNA Registry, Rheumatology, Volume 64, Issue 4, April 2025, Pages 1880–1885, https://doi.org/10.1093/rheumatology/keae341
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Abstract
The predictive validity of disease-specific quality of life (QOL) remains unknown in patients with systemic lupus erythematosus (SLE), although disease-specific measures are equally or more responsive to changes than generic QOL. We aimed to examine the predictive validity of the Lupus Patient-Reported Outcome (PRO) for damage accrual.
Patients with SLE and ≥2 measurements over time were included in the Japanese nationwide multicentre registry (LUNA). The Lupus PRO questionnaire contains both health-related (HR) and non-HR QOL measures. Damage accrual was evaluated using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). We examined the association between the Lupus PRO score at baseline and longitudinal SDI scores using mixed-effects models adjusted for prognostic factors.
Among 1295 patients, those with higher HR-QOL of Lupus PRO at baseline demonstrated a significantly lower increase in SDI (−0.005/year, 95% confidence interval [CI]: −0.007 to −0.004, P < 0.001). According to the categorization of HR-QOL based on tertile, a similar dose-dependent effect of HR-QOL on longitudinal SDI was identified (second vs first tertile category: −0.101/year, 95% CI: −0.172 to −0.030; third tertile category: −0.211/year, 95% CI: −0.281 to −0.142). Non-HR-QOL was not significantly associated with the SDI scores. Among the HR-QOL domains, cognition, procreation and physical health were significantly associated with the total SDI scores over time. HR-QOL was associated with corticosteroid-dependent and -independent SDI scores.
A higher HR-QOL of Lupus PRO was associated with a lower increase in SDI scores. Our findings imply the importance of disease-specific HR-QOL measurements in assessing prognosis.
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