Predictive validity of Lupus Patient-Reported Outcome for damage accrual in patients with systemic lupus erythematosus: the LUNA Registry

• Published in: Rheumatology (Oxford, England)
• Main Authors: Nose, Yoko, Onishi, Akira, Nishimura, Keisuke, Yamamoto, Yuzuru, Sada, Ken-Ei, Ichinose, Kunihiro, Yoshimi, Ryusuke, Ohno, Shigeru, Yanai, Ryo, Kajiyama, Hiroshi, Sato, Shuzo, Shimojima, Yasuhiro, Fujiwara, Michio, Kida, Takashi, Miyawaki, Yoshia, Matsuo, Yusuke, Tsuji, Hideaki, Morinobu, Akio, Saegusa, Jun
• Format: Journal Article
• Language: English
• Published: England 17.06.2024
• Subjects: patient-reported outcome; predictive validity; systemic lupus erythematosus; damage accrual; Lupus PRO
• ISSN: 1462-0324; 1462-0332; 1462-0332
• DOI: 10.1093/rheumatology/keae341

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 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 categorisation 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.