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Lupus Remission: How Do Patient and Physician Perceptions Align?

Chiara Orlandi1,2, Micaela Fredi1,2, Cesare Tomasi1,2

  • 1Rheumatology and Clinical Immunology, ASST Spedali Civili of Brescia, ERN-ReCONNET Center, 25123 Brescia, Italy.

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Summary
This summary is machine-generated.

Even in clinical remission, systemic lupus erythematosus (SLE) patients experience significant burden impacting quality of life. Addressing pain, psychological distress, and functional disability is crucial for comprehensive SLE care.

Keywords:
discrepancypatient-reported outcomesremission

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Area of Science:

  • Rheumatology
  • Patient-Reported Outcomes
  • Clinical Research

Background:

  • Clinical remission is a key goal in systemic lupus erythematosus (SLE) management, linked to better long-term outcomes.
  • However, the impact of remission on patient-reported burden, quality of life, and disease perception is not fully understood.

Purpose of the Study:

  • To assess patient-reported outcomes (PROs) in SLE patients achieving clinical remission.
  • To identify factors linked to reduced health-related quality of life (HRQoL).
  • To evaluate discordance between patient and physician assessments of disease activity.

Main Methods:

  • 106 adult SLE patients in clinical remission were analyzed.
  • PRO measures included SF-36, pain VAS, depression, anxiety, and insomnia scales.
  • Physician and patient global assessments (PGA/PhGA) were compared to identify discordance.

Main Results:

  • Nearly half of patients reported depressive symptoms (47.1%), with significant anxiety and insomnia.
  • Patients on corticosteroids reported worse outcomes than those in complete remission or off corticosteroids.
  • Functional disability, pain, and depression correlated with poorer physical HRQoL; anxiety correlated with poorer mental HRQoL.
  • Physician-patient discordance occurred in 22.6%, often due to higher patient-reported pain.

Conclusions:

  • A significant patient burden persists in SLE patients despite clinical remission.
  • Pain, psychological distress, insomnia, and functional disability impair HRQoL.
  • Findings advocate for a patient-centered approach to SLE remission assessment.