Health status in systemic lupus erythematosus compared to rheumatoid arthritis and healthy controls

Objective. To examine health status in systemic lupus erythematosus (SLE), using both generic and arthritis-specific instruments, and compare the health status in patients with SLE to matched patients with rheumatoid arthritis (RA) and matched healthy controls. As well, to study possible correlations between health status measures and demographic and disease variables in the patients with SLE. Methods. Patients were recruited from the Oslo county registers of patients with SLE and RA, and the healthy controls from the county population register. Measures of health status (Medical Outcome Survey SF-36, joint pain and fatigue on visual analog scale, Modified Health Assessment Questionnaire) were obtained from 82 SLE and 82 RA patients matched for age, sex, and disease duration, and from 74 age and sex matched healthy controls. Disease activity and organ damage were assessed in the patients with SLE. Results. Patients with SLE were significantly more affected in all dimensions of health status compared to controls, except in the SF-36 category role-emotional. Further, patients with SLE were significantly less affected than patients with RA with regard to physical function and joint pain, but scores were similar in all other dimensions of health status. Scores of health status correlated more strongly to the damage index than to disease activity, indicating that health status measures capture some of the same concept as the damage index, namely the consequence of the disease over time. Conclusion. Our study showed that patients with SLE and RA have a multidimensional involvement of health status compared to healthy controls. The findings call for a biopsychosocial approach in the management of SLE.