Using Clinical Characteristics and Patient-Reported Outcome Measures to Categorize Systemic Lupus Erythematosus Subtypes.
Journal Article (Journal Article)
OBJECTIVE: The type 1 and type 2 systemic lupus erythematosus (SLE) categorization system was recently proposed to validate the patients' perspective of disease and to capture a more comprehensive spectrum of symptoms. The objective of this study was to characterize the clinical manifestations of SLE subtypes and to determine the correlation between the patient- and physician-reported measures used in the model. METHODS: This was a cross-sectional study of patients with SLE in a university clinic. Patients completed the Systemic Lupus Activity Questionnaire (SLAQ) and 2011 American College of Rheumatology fibromyalgia (FM) criteria. Active SLE was defined as Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score ≥6, clinical SLEDAI score ≥4, or active lupus nephritis. We identified 4 groups: type 1 SLE (active SLE without FM), type 2 SLE (inactive SLE with FM), mixed SLE (active SLE with FM), and minimal SLE (inactive SLE without FM). RESULTS: In this cohort of 212 patients (92% female, mean age 45 years), 30% had type 1 SLE, 8% had type 2 SLE, 13% had mixed SLE, and 49% had minimal SLE. Regardless of SLE disease activity, patients with FM (21%), reported higher SLAQ scores, patient global assessment scores, and self-reported lupus flare that resulted in discordance between patient- and physician-reported measures. CONCLUSION: Fatigue, widespread pain, sleep dysfunction, and mood disorders are common symptoms in SLE. Identifying these symptoms as type 2 SLE may be a method to improve patient communication and understanding. The level of type 2 SLE impacts patients' perception of disease and self-reported symptoms. The SLAQ may need to be reinterpreted based on the FM severity scale.
Full Text
Duke Authors
- Clowse, Megan Elizabeth Bowles
- Criscione-Schreiber, Lisa Giorgina
- Eudy, Amanda Marie
- Pisetsky, David Stephen
- Sun, Kai
Cited Authors
- Rogers, JL; Eudy, AM; Pisetsky, D; Criscione-Schreiber, LG; Sun, K; Doss, J; Clowse, MEB
Published Date
- March 2021
Published In
Volume / Issue
- 73 / 3
Start / End Page
- 386 - 393
PubMed ID
- 31909888
Electronic International Standard Serial Number (EISSN)
- 2151-4658
Digital Object Identifier (DOI)
- 10.1002/acr.24135
Language
- eng
Conference Location
- United States