Impact of Joint Involvement on Patients Reported Outcomes in Systemic Lupus Erythematosus

Objective: Joint involvement is common among patients with systemic lupus erythematosus (SLE). Aim of this work was to evaluate the correlation between the presence of joint involvement and patient-reported pain, perception of disease activity, general health and quality of life. Methods: Fifty consecutive SLE patients were enrolled in the study. All patients underwent a complete clinical evaluation including a 44-joint count; in addition, an ultrasound evaluation of joint involvement of hands and wrists was performed. The following patients reported outcomes (PROs) were completed: Visual Analog Scales 0-100 mm (VAS) evaluating patients reported pain, patient's perception of global disease activity and general health (GH) and a validated Italian version of the Health Assessment Questionnaire (HAQ). Results: Fourteen patients (28%) reported a significant morning stiffness lasting for more than 30 minutes; hand or wrist arthritis was clinically detectable in 10 (20%) patients, while the US evaluation exhibited at least one joint or tendon pathology in 18 patients (36%). The mean VAS score for pain and disease activity perception was 27 (+/- 27.7) mm and 25.3 (+/- 25.2) mm, respectively, the mean of GH score was 33.2 (+/- 24.3) mm, and the mean HAQ score was 0.34 (+/- 0.5). A significant correlation was observed between VAS score for pain, patient's perception of disease activity and GH and the presence of arthritis. Conclusion: PROs may play an important role in guiding therapeutic decisions and suggest the utility of ultrasound evaluation in patients reporting articular symptoms.