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The Impact of Belimumab and Rituximab on Health-Related Quality of Life in Patients With SystemicLupus Erythematosus
Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden; Odense Univ Hosp, Denmark.
Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
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2019 (English)In: Arthritis care & research, ISSN 2151-464X, E-ISSN 2151-4658, Vol. 71, no 6, p. 811-821Article in journal (Refereed) Published
Abstract [en]

ObjectiveAccumulating evidence supports an impaired health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE). We investigated the effects of 2 biologic treatments on HRQoL of patients with SLE. MethodsPatients with SLE from the Karolinska University Hospital treated with belimumab (n = 34) or rituximab (n = 35) were included; normative values derived from Swedish population-based controls matched for age and sex were used for the purpose of comparisons. Data were collected prospectively at treatment initiation and at months 3, 6, 12, and 24, using the Short Form 36 (SF-36) health questionnaire, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) scale, the EuroQol 5-dimension (EQ-5D) instrument, and the Stanford Health Assessment Questionnaire disability index (HAQ DI). ResultsSubstantial decrements from Swedish norms were observed across all SF-36 domains at baseline. Patients treated with belimumab reported gradual improvements in the SF-36 physical component summary (significant from month 12; P = 0.023) and FACIT-Fatigue (significant by month 24; P = 0.001), no changes in EQ-5D scores, and improvements in HAQ DI by month 6 (P = 0.014). Patients treated with rituximab showed rapid improvements in the SF-36 mental component summary and FACIT-Fatigue by month 3 (P = 0.031 and P = 0.007, respectively), as well as improvements in EQ-5D at month 6 (P = 0.016) and HAQ DI at month 3 (P = 0.033). Based on baseline evaluations, patients receiving antimalarial agents (n = 33) performed better in the SF-36 social functioning (P = 0.022) and mental health (P = 0.023) domains compared to patients who did not receive antimalarial agents (n = 36). ConclusionOur results corroborated previous findings of considerable HRQoL impairments in patients with SLE. Patients perceptions of HRQoL showed discrepant patterns over time in the 2 treatment groups and could provide additional information along with the clinical evaluation of biologic therapy in SLE. Further survey on the effects of antimalarial agents on the HRQoL of patients with SLE in larger cohorts is merited.

Place, publisher, year, edition, pages
WILEY , 2019. Vol. 71, no 6, p. 811-821
National Category
Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:liu:diva-159167DOI: 10.1002/acr.23718ISI: 000474808500012PubMedID: 30055091OAI: oai:DiVA.org:liu-159167DiVA, id: diva2:1339552
Note

Funding Agencies|Swedish Rheumatism Association; King Gustaf Vs 80-Year Foundation; Professor Nanna Svartz Foundation; Swedish Research Council; Stockholm County Council (ALF); Karolinska Institutet Foundations

Available from: 2019-07-30 Created: 2019-07-30 Last updated: 2019-07-30

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Welin, Elisabet
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Division of Nursing ScienceFaculty of Medicine and Health SciencesDepartment of Rheumatology
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