Rheumatology Medical News about childhood-onset systemic lupus erythematosus;patient disease course;quality of life

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Brunner HI et al. – Study reports that health-related quality of life (HRQOL) in children with childhood-onset systemic lupus erythematosus (cSLE) was significantly lower vs healthy populations, with a differential effect due to organ-specific involvement. Higher disease activity and damage are associated with lower HRQOL, and worsening of cSLE leads to a further decline.

Methods

Main objectives of this study were to:
1. Estimate HRQOL of children with cSLE vs normative cohorts
2. Assess the relationship of HRQOL with cSLE disease activity and damage, and
3. Determine the effects of changes of disease activity on HRQOL
Pts (n=98) followed every 3 months completed HRQOL measures:
- Pediatric Quality of Life Inventory Generic Core scale (PedsQL-GC)
- Rheumatology Module (PedsQL-RM), and
- Child Health Questionnaire (CHQ)
British Isles Lupus Activity Group Index (BILAG) was used to measure organ-system-specific disease activity
Physicians rated the course of cSLE between visits

Results

At baseline, mean score of the PedsQL-GC and the PedsQL-RM was 75 and 79 respectively
Mean of the CHQ physical summary score (CHQ-PHS) was 49 and that of the CHQ psychological summary score was 42
Higher BILAG scores, especially in the general, musculoskeletal, neurological, and vascular, but not the mucocutaneous, renal, cardiovascular, or hematological BILAG domains, were associated with a lower HRQOL
Pts with damage had lower HRQOL vs those w/o damage
All HRQOL measures included were at most modestly responsive to clinically important changes with cSLE

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