Complementary or alternative therapy use and health status in systemic lupus erythematosus

Despite their unproven efficacy and safety concerns, complementary and alternative therapies (CAT) are used by a high proportion of patients with systemic lupus erythematosus (SLE). A prospective survey of past and present CAT use was done on 192 patients (36.5 +/- 12.7 years; 106 +/- 85 months of disease duration; 94% women) with an SLE diagnosis according to ACR criteria. Quality of life [Short Form 36 (SF-36)] and cumulated damage (SLICC/ACR) were compared between CAT users and non-users. In all, 103 (53.6%; 95% CI: 46.8-60.9) patients were CAT users (median: two remedies/patient): two (1%) in the alternative mode (CAT instead of allopathic treatment); 101 (52.6%) in the complementary mode (CAT in addition to allopathic treatment). A univariate analysis showed CAT users to have higher cumulated damage (P = 0.01) levels, as well as lower physical function (P = 0.05), social function (P = 0.05) and bodily pain (P = 0.02) domain scores in the SF-36 survey. After adjustment for disease duration with a linear model, only differences in bodily pain (P = 0.04) and cumulated damage (P = 0.05) remained statistically significant. CAT use is apparently associated with lower health status in patients with SLE from Yucatan, Mexico. Because the study was cross-sectional, more research is needed to define the directionality of this association.