Differences in quality of life determinants according to the presence of fibromyalgia in middle‐aged female patients with systemic lupus erythematosus: a multicenter, cross‐sectional, single‐ethnicity cohort

Moon, Su‐Jin; Kang, Kwi Young; Kwok, Seung‐Ki; Hong, Yeon-Sik; Park, Sung-Hwan; Jeon, Chan Hong; Choi, Sang Tae; Song, Jung Soo; Min, Jun-Ki

doi:10.1111/1756-185x.13320

Cited by 18 publications

(23 citation statements)

References 40 publications

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“…Thus, SARD patients did not solely meet fibromyalgia criteria based upon their fatigue symptoms, but also had substantial unexplained generalized pain consistent with this diagnosis. These findings are compatible with previous studies that found an increased prevalence of fibromyalgia in SARD patients, either when diagnosed using conventional clinical criteria or the diagnostic criteria used in this study [47–50].…”

Section: Discussionsupporting

confidence: 93%

Fatigue severity in anti-nuclear antibody-positive individuals does not correlate with pro-inflammatory cytokine levels or predict imminent progression to symptomatic disease

et al. 2019

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BackgroundFatigue is a common symptom of systemic autoimmune rheumatic disease (SARD). Patients with SARD have a protracted pre-clinical phase during which progressive immunologic derangements occur culminating in disease. In this study, we sought to determine when fatigue develops and whether its presence correlates with inflammatory factors or predicts disease progression.MethodsAnti-nuclear antibody (ANA)-negative healthy controls (HCs) and ANA-positive participants with no criteria, at least one clinical criteria (undifferentiated connective tissue disease, UCTD), or meeting SARD classification criteria were recruited. Fatigue was assessed using a modified version of the FACIT-F questionnaire and the presence of fibromyalgia determined using a questionnaire based on the modified 2010 ACR criteria. Peripheral blood expression of five IFN-induced genes was quantified by NanoString and the levels of IL-1β, IL-6, or TNF-α by ELISA.ResultsFatigue was as prevalent and severe in individuals lacking SARD criteria as it was in UCTD and SARD. Overall, ~ 1/3 of ANA+ subjects met fibromyalgia criteria, with no differences between sub-groups. Although fatigue was more severe in these individuals, those lacking fibromyalgia remained significantly more fatigued than ANA− HC. However, even in these subjects, fatigue correlated with the widespread pain index and symptom severity scores on the fibromyalgia questionnaire. Fatigue was not associated with elevated cytokine levels in any of the ANA+ sub-groups and did not predict imminent disease progression.ConclusionsFatigue is common in ANA+ individuals lacking sufficient criteria for a SARD diagnosis, correlates with fibromyalgia-related symptoms, and is not associated with inflammation or predictive of disease progression.

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Section: Discussionsupporting

confidence: 93%

Fatigue severity in anti-nuclear antibody-positive individuals does not correlate with pro-inflammatory cytokine levels or predict imminent progression to symptomatic disease

et al. 2019

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“…A total of 70 unique publications (3,4,10,11, comprised of 27 clinical studies, 16 epidemiologic studies, and 27 studies reporting economic and humanistic burden and unmet need met the inclusion criteria (see Supplementary Appendix C, available at http:// onlinelibrary.wiley.com/doi/10.1002/acr.24431/abstract). Most of the studies were conducted in China (n = 14) (11,19,21,23,28,29,38,43,47,54,59,78,79,82), Japan (n = 13) (31,(33)(34)(35)(36)(37)40,58,65,67,74,75,77), and Taiwan (n = 12) (20,22,24,25,45,52,56,60-62, 64,69), followed by Korea (n = 9) (17,26,32,42,44,53,63,72,76), Australia (n = 7) (4,18,39,49,50,57,…”

Section: Resultsmentioning

confidence: 99%

“…Disease characteristics of patients in included studies. Disease characteristics were reported for SLE patients in studies from Australia (n = 6) (4,18,39,50,57,66), China (n = 15) (11,19,21,23,28,29,38,43,47,54,59,78,79,82), Hong Kong (n = 6) (10,30,46,71,80,81), Japan (n = 13) (31,(33)(34)(35)(36)(37)40,58,65,67,74,75,77), Korea (n = 7) (17,26,41,42,44,63,72), Singapore (n = 4) (27,48,55,70), and Taiwan (n = 10) (20,22,24,25,45,52,…”

Section: Significance and Innovationsmentioning

confidence: 99%

Systemic Lupus Erythematosus: Targeted Literature Review of the Epidemiology, Current Treatment, and Disease Burden in the Asia Pacific Region

Tanaka

O’Neill

et al. 2022

Arthritis Care & Research

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Objective. To understand the epidemiology, current treatment, and disease burden of systemic lupus erythematosus (SLE) in the Asia Pacific (APAC) region.Methods. A targeted literature review of published evidence on SLE in the APAC region was conducted, using the Medline database (2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018), conference proceedings, and other supplementary sources.Results. The current review identified 70 studies conducted in China (n = 15), Japan (n = 13), Taiwan (n = 12), Korea (n = 9), Australia (n = 7), Hong Kong (n = 6), Singapore (n = 4), and multiple places within the APAC region (n = 4). Incidence rates (per 100,000 persons per year) ranged from 0.9-8.4, while prevalence rates ranged from 3.7-127 (per 100,000 persons); however, recent data were limited. Asian patients with SLE were reported to have higher disease severity, disease activity (higher SLE disease activity index scores), and organ damage accrual, along with increased morbidity, mortality, and susceptibility to renal involvement compared with other ethnicities in the APAC region. The risk of developing SLE is higher in the Asian population. Routinely used SLE therapies included belimumab, hydroxychloroquine, cyclophosphamide, tacrolimus, azathioprine, mycophenolate mofetil, and glucocorticoids; however, prescribing patterns varied across the region. Increased disease activity was associated with high economic burden and poor quality of life for SLE patients in the APAC region.Conclusion. SLE remains a disease with a significant unmet medical need for an innovative therapy that is well-tolerated and effective for patients in the APAC region. Further evidence is required to better characterize the disease and fully capture the burden and impact of SLE in the APAC region. This review has highlighted where there is a paucity of data from patients across the APAC region.

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“…Thirdly, we did not have information on concomitant diagnosis of fibromyalgia which is known to impact QOL in SLE patients. 35 Lastly, for the mediation analysis we needed to transform mediator and PRO variables, thus the magnitude of direct and indirect effect could not be easily interpreted. However, the intent of the mediational model analysis was to primarily confirm whether disease activity mediated the relationship between HCQ and PROs.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Does hydroxychloroquine improve patient reported outcomes in patients with lupus?

Jolly

Sehgal

Arora

et al. 2021

Lupus

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Background Hydroxychloroquine (HCQ) use is associated with less disease activity, flares, damage and improved survival in Systemic Lupus Erythematosus (SLE). However, its effect on patient reported health outcomes (PROs) such as quality of life (QOL) is not known. Methods International data from Study on Outcomes of Lupus (SOUL) from 2,161 SLE patients were compared by HCQ use. Disease activity and damage were assessed using SELENA-SLEDAI and SLICC-ACR/SDI. QOL was evaluated using LupusPRO and Lupus Impact Tracker (LIT). Linear regression analyses were performed with LupusPRO summary scores health related HRQOL, non-health related NHRQOL and LIT as dependent and HCQ use as independent variable. Analyses were undertaken to test mediation of effects of HCQ use on QOL through disease activity. Results Mean age was 40.5 ± 12.8 years, 93% were women. Sixty-three (1363/2161) percent were on HCQ. On univariate analysis, HCQ use was associated with (a) better QOL (LupusPRO-HRQOL: β 6.19, 95% CI 4.15, 8.24, P ≤ 0.001, LupusPRO NHRQOL: β 5.83, 95% CI 4.02, 7.64, P ≤ 0.001) and less impact on daily life (LIT: β −9.37, 95% CI −12.24, −6.50, P ≤ 0.001). On multivariate and mediational analyses, the effects of HCQ on QOL were indirectly and completely mediated through disease activity. Conclusions HCQ use in SLE is associated with better patient reported health outcomes (LupusPRO-HRQOL and NHRQOL and impact on daily life), and the effects are mediated through disease activity. This information can facilitate patients and physician’s communication with decision-making regarding the use of HCQ for SLE management.

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Differences in quality of life determinants according to the presence of fibromyalgia in middle‐aged female patients with systemic lupus erythematosus: a multicenter, cross‐sectional, single‐ethnicity cohort

Abstract: Poor sleep quality is the common independent risk factor for poor HRQoL in both middle-aged SLE patients with fibromyalgia and without fibromyalgia. Sleep quality improvement may improve HRQoL in female SLE patients, even in those without fibromyalgia.

Cited by 18 publications

References 40 publications

Fatigue severity in anti-nuclear antibody-positive individuals does not correlate with pro-inflammatory cytokine levels or predict imminent progression to symptomatic disease

Fatigue severity in anti-nuclear antibody-positive individuals does not correlate with pro-inflammatory cytokine levels or predict imminent progression to symptomatic disease

Systemic Lupus Erythematosus: Targeted Literature Review of the Epidemiology, Current Treatment, and Disease Burden in the Asia Pacific Region

Does hydroxychloroquine improve patient reported outcomes in patients with lupus?

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