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Differential impact of systemic lupus erythematosus and rheumatoid arthritis on health-related quality of life

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Abstract

Purpose

This study examined and compared health-related quality of life (QoL) in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).

Methods

We included patients from two multicentric cohorts, the Swiss SLE cohort study (SSCS) and the Swiss Clinical Quality Management Program for RA (SCQM-RA). Patients were matched by age, sex and disease duration using the propensity score. Disease activity was assessed by SELENA-SLEDAI in SLE and by DAS-28 in RA. QoL was captured by the short-form 36 (SF-36). The primary outcomes were physical component summary (PCS) and mental component summary (MCS) of the SF-36. Generalized estimating equation models were used to assess evolution over time.

Results

We analyzed 267 SLE patients and 267 matched RA patients. More patients with RA had active disease and more patients with SLE had immunosuppressant therapies at baseline. The median [interquartile range (IQR)] MCS and PCS scores were 45.1 [33.7–52.6] and 45.6 [38.0–53.0] in SLE and 48.8 [37.6–56.7] and 34.7 [26.8–43.0] in RA, respectively (ps < 0.001). Over one year the differences persisted, although PCS and MCS increased in RA (ps < 0.001) but not in SLE in the univariate analysis. The differences in MCS and PCS scores between RA and SLE remained qualitatively similar after adjustment for patient characteristics, treatment, and activity disease.

Conclusions

SLE and RA both affect QoL. Patients with SLE have lower MCS, whereas patients with RA have lower PCS. These differences remained over 1 year of follow up, suggesting fundamental dissimilarities between SLE and RA in their impact on QoL.

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Acknowledgements

The authors thank Mr. David Neto for his support for data management in the study. This work was supported in part by the Gebert-Rüf Foundation (Grant Number GRS-027/07). The SCQM is financially supported by pharmaceutical industries and donors. A list of financial supporters can be found on http://www.scqm.ch/sponsors.

Author contributions

BC, AF, DAR, DC, CR, CC acquired data; BC, DAR, DC performed statistical analysis; BC, CC drafted the manuscript; BC, AF, DAR, DC, CR, CC provided critical reading and approved the final manuscript.

SSCS contributors

Eric Dayer (Clinical Immunology and Allergy, Sion Hospital, Switzerland), Thomas Hauser (Clinical Immunology and Allergy, Zurich, Switzerland), Uyen Huynh-Do (Nephrology, University Hospital Bern, Switzerland), Annette Leimgruber (Clinical Immunology and Allergy, Lausanne, Switzerland), Johannes von Kempis (Rheumatology, Kantonsspital St Gallen, Switzerland), Petra Otto (Rheumatology, Kantonsspital St Gallen, Switzerland), Thomas Stoll (Rheumatology, Kantonsspital Schaffhausen, Switzerland), Marten Trendelenburg (Internal Medicine and Clinical Immunology Lab, Department of Biomedicine, University Hospital Basel, Switzerland).

SCQM contributors

A list of rheumatology offices and hospitals that are contributing to the SCQM registries can be found on http://www.scqm.ch/institutions.

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Authors and Affiliations

  1. Clinical Immunology and Allergy, Department of Internal Medicine Specialties, University Hospital and School of Medicine, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland

    Benjamin Chaigne & Carlo Chizzolini

  2. Rheumatology, Department of Internal Medicine Specialties, University Hospital and School of Medicine, Geneva, Switzerland

    Axel Finckh, Deshire Alpizar-Rodriguez & Delphine Courvoisier

  3. Division of Immunology and Allergy, University Hospital, Lausanne, Switzerland

    Camillo Ribi

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  1. Benjamin Chaigne
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  2. Axel Finckh
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For The Swiss Clinical Quality Management Program For Rheumatoid Arthritis

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Correspondence to Carlo Chizzolini.

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Chaigne, B., Finckh, A., Alpizar-Rodriguez, D. et al. Differential impact of systemic lupus erythematosus and rheumatoid arthritis on health-related quality of life. Qual Life Res 26, 1767–1775 (2017). https://doi.org/10.1007/s11136-017-1534-4

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