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Impact of disease activity and cumulative damage on the health of lupus patients
P R Fortin
Division of Clinical Epidemiology of The Montreal General Hospital; Department of Medicine of McGill University; Division of Rheumatology of The Montreal General Hospital and Department of Medicine of McGill University
M Abrahamowicz
Division of Clinical Epidemiology of The Montreal General Hospital; Department of Medicine of McGill University; Department of Epidemiology and Biostatistics of McGill University
C Neville
Division of Clinical Epidemiology of The Montreal General Hospital; Department of Medicine of McGill University; Division of Rheumatology of The Montreal General Hospital and Department of Medicine of McGill University
R du Berger
Division of Clinical Epidemiology of The Montreal General Hospital; Department of Medicine of McGill University
L Fraenkel
Arthritis Centre of Boston University Medical Centre and Boston University
A E Clarke
Division of Clinical Epidemiology of The Montreal General Hospital; Department of Medicine of McGill University; Division of Clinical Immunology of The Montreal General Hospital and Department of Medicine of McGill University
D Danoff
Division of Clinical Immunology of The Montreal General Hospital and Department of Medicine of McGill University
To test if lupus activity and damage predict physical function and general health in lupus was the objective of this study. Ninety-six patients with lupus were seen at baseline and monthly for 4 months. Sociodemographic characteristics and lupus damage (SLICC/ACR DI), were collected at baseline while lupus activity (SLAM-R, SLEDAI), health status measures (HAQ, SF-36TM) and immunological tests were collected at each visit. Associations of lupus activity and damage with general health and physical function were evaluated. Baseline health status measures were greatly impaired and comparable to those of severe medical illnesses. In cross-sectional analyses, baseline activity score measured by SLAM-R, but not by SLEDAI, correlated with most subscales of SF-36TM. Baseline damage score SLICC ACR DI correlated only with the HAQ and the physical function subscale of SF-36TM. Differences in both activity measures (SLAM-R and SLEDAI) over time correlated with change in health status measures while baseline cumulative damage (SLICC/ACR DI) correlated with the average level of physical function only. Lupus activity measures, SLAM-R and SLEDAI, although differing cross-sectionally, both reflected patients' health status performance over time and lupus damage measure, SLICC/ACR DI, performed well in assessing physical function. Lupus patients scores for health are poor and comparable to those found in severe medical illnesses.
Key Words: health status • physical function • activity • damage
Lupus, Vol. 7, No. 2,
101-107 (1998)
DOI: 10.1191/096120398678919813
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