Disease activity, cumulative damage and quality of life in systematic lupus erythematosus: Results of a cross-sectional study

The relationship between disease activity, cumulative damage and self-reported quality of life was examined in 96 patients with Systematic Lupus Erythematosus (SLE). Disease activity was measured by the SLE Disease Activity Index (SLEDAI) and cumulative damage by the Systematic Lupus International Cooperating Clinics/ACR damage index (DI). Quality of life was assessed by the Medical Outcomes Survey Short Form 20 (SF-20) self-report questionnaire which consists of six subscales. The study population was predominantly Caucasian (91%) and female (90%). The mean (+/- s.d.) age was 42.0 +/- 11.0 years and disease duration was 7.5 +/- 5.5 years. SLEDAI scores varied from 0-28, with a mean (+/- s.d.) of 4.8 +/- 5.2. The mean (+/- s.d.) DI score was 0.74 +/- 1.06, with a range of 0-5. Subscales of the SF-20 varied from 0-100 and the range of mean (+/- s.d.) scores varied from 35.0 +/- 42.2 to 70.5 +/- 28.7. There was no correlation between SLEDAI and DI scores or between SLEDAI scores and any of the six subscales of the SF-20. Likewise there was no correlation between DI scores and SF-20 subscales with the exception of Health perception (r = 0.34, P = 0.02). These results indicate that there are at least three independent dimensions of health status in SLE, namely disease activity, cumulative damage and quality of life. Furthermore, the extent of inflammatory disease activity and irreversible target organ damage are not the sole determinants for quality of life in SLE patients.