Disease-specific quality of life in patients with lupus nephritis
Disease-specific quality of life in patients with lupus nephritis
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DOI：
10.1177/0961203317717082
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发表时间：
2018-02-01
期刊：
影响因子：
2.6
通讯作者：
Mok, C. C.
中科院分区：
文献类型：
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作者：
Jolly, M.;Toloza, S.;Mok, C. C.
背景：狼疮性肾炎（LN）患者报告的结局尚未得到很好的研究。尚不存在LN中疾病靶向PRO工具的研究。在此，我们描述生活质量（QOL：HRQOL和非HRQOL）LN患者使用LupusPRO.Methods国际，横断面数据从1259例系统性红斑狼疮（SLE）和LupusPRO进行了比较，分层（a）LN（ACR分类标准（ACR-LN））的存在下，在任何时间，（B）活动LN（对SLEDAI）在研究访问。通过SLICC/ACR-SDI评估损伤。对ACR-LN（活动性LN）调整后的年龄，性别，种族和国家的招聘multicarianregression analysisofQOL carried.Results平均（SD）年龄为41.7（13.5）岁，93%是女性。1259例SLE患者中有539例发生ACR-LN。ACR-LN组较非ACR-LN组更年轻，更常使用免疫抑制剂，狼疮药物和生育方面的生活质量较差。两组的HRQOL和非HRQOL评分相似。539例ACR-LN患者中有129例为活动性LN。活动性LN组较非活动性LN组年轻，疾病活动性更大，HRQOL和非HRQOL更差。具体领域受到不利影响的狼疮症状，狼疮药物，生殖，情绪健康，身体形象和愿望目标域。ACR-LN和活动性LN患者表现出显着恶化狼疮药物和生殖HRQOL域，即使调整年龄，种族，性别和国家的招聘。结论狼疮肾炎患者的生活质量差。活动性LN患者的HRQOL和非HRQOL较差。大多数受影响的领域不包括在SLE中使用的通用QOL工具中。LN患者必须接受讨论狼疮药物和生育问题。活动性LN患者需要全面评估和解决生活质量，沿着活动性LN的治疗。
Background Patient-reported outcomes in lupus nephritis (LN) are not well studied. Studies with disease-targeted PRO tool in LN do not exist. Herein, we describe quality of life (QOL: HRQOL & non-HRQOL) among LN patients using LupusPRO.Methods International, cross-sectional data from 1259 patients with systemic lupus erythematosus (SLE) and LupusPRO were compared, stratified by (a) presence of LN (ACR classification criteria (ACR-LN)) at any time and, (b) active LN (on SLEDAI) at study visit. Damage was assessed by SLICC/ACR-SDI. Multivariate regression analyses for QOL against ACR-LN (active LN) after adjusting for age, gender, ethnicity and country of recruitment were performed.Results Mean (SD) age was 41.7 (13.5) yrs, 93% were women. Five hundred and thirty-nine of 1259 SLE patients had ACR-LN. ACR-LN group was younger, were more often on immunosuppressive medications, had worse QOL on lupus medications and procreation than non-ACR-LN patients. HRQOL and non-HRQOL scores were similar in both groups. One hundred and twenty-nine of 539 ACR-LN patients had active LN. Active LN group was younger, had greater disease activity and had worse HRQOL and non-HRQOL compared to patients without active LN. Specific domains adversely affected were lupus symptoms, lupus medications, procreation, emotional health, body image and desires-goals domains. Patients with ACR-LN and active LN fared significantly worse in lupus medications and procreation HRQOL domains, even after adjusting for age, ethnicity, gender and country of recruitment.Conclusions Lupus nephritis patients have poor QOL. Patients with active LN have worse HRQOL and non-HRQOL. Most domains affected are not included in the generic QOL tools used in SLE. LN patients must receive discussion on lupus medications and procreation issues. Patients with active LN need comprehensive assessments and addressal of QOL, along with treatment for active LN.