RISK FACTORS OF LIFE QUALITY REDUCTION IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Abstract

It is a known fact that the presence of a chronic disease or chronic pain syndrome reduces the quality of life (QoL). Despite considerable achievements in the diagnostics and treatment of systemic lupus erythematosus (SLE) over the past decades and improvements in the long-term prognosis of patients, many challenges remain unsolved. The investigation of the quality of life can help to comprehensively evaluate patients' health, the effectiveness and safety of treatment and identify other causes of reduced quality of life that are not directly related to the disease. Aim of the academic paper lies in evaluating quality of life parameters using the SF-36 questionnaire in patients with SLE and analyzing risk factors for its reduction. Materials and Methods. A questionnaire was conducted using the Medical Outcomes Study Short Form 36 questionnaire (SF-36) of 36 patients with systemic lupus erythematosus aged 18 to 62 years, regardless of disease activity at the time of examination, and 24 practically healthy persons, comparable in age and gender ratio. The main parameters of the quality of life in the 2 groups were compared, as well as their dependence on clinical manifestations and therapy was studied. Results and Dyscussion. Physical well-being in patients with SLE (29.6±2.97) is significantly lower (p<0.001) than in healthy individuals (55.8±3.31). The level of mental well-being does not differ significantly, but its components, such as social functioning (p=0.047) and vital activity (p=0.01) are reduced in patients with SLE. The level of physical well-being is lower in the groups of patients with the presence of arthritis (p=0.026), avascular necrosis of the femoral head before surgery (p=0.019) and skin rash (p=0.032) in the clinical picture compared to patients without these manifestations. The use of cyclophosphamide (p=0.046) and mycophenolate mofetil (p=0.012) is associated with a higher level of mental well-being. Conclusions. Patients with SLE have a lower level of quality of life compared to healthy individuals of the corresponding age and gender. The risk factors for reducing the level of physical well-being are the presence of arthritis, skin rash and avascular necrosis of the femoral head (prior to surgical intervention). The level of mental well-being is significantly higher among patients taking cyclophosphamide and/or mycophenolate mofetil. Abbreviations: ACR - American College of Rheumatology AIDS - acquired immunodeficiency syndrome ANFH - avascular necrosis of femoral head CF - Cyclophosphamide EULAR - The European Alliance of Associations for Rheumatology GC - glucocorticoids MMF - Mycophenolate mofetil SLE - systemic lupus erythematosus SLICC - The Systemic Lupus Erythematosus International Collaborating Clinics QoL - Quality of life