1702 Patients enrolled in the accelerating medicines partnership (AMP) RA/SLE network with isolated renal disease report minimal quality of life impairment on PROMIS-29 compared to patients with extrarenal symptoms

• Published in: Lupus science & medicine 2022-12, Vol.9 (Suppl 3), p.A102-A103
• Main Authors: Carlucci, Philip, Li, Jessica, Gold, Heather T, Deonaraine, Kristina, Fava, Andrea, Buyon, Jill, James, Judith A, Putterman, Chaim, Rao, Deepak, Diamond, Betty, Fine, Derek, Monroy-Trujillo, Jose, Haag, Kristin, Apruzzese, William, Michael Belmont, H, Connery, Sean, Payan-Schober, Fernanda, Furie, Richard, Berthier, Celine, Dall’Era, Maria, Cho, Kerry, Kamen, Diane, Kalunian, Kenneth, Anolik, Jennifer, Serrate-Sztein, Susana, Izmirly, Peter, Petri, Michelle
• Format: Article
• Language: English
• Subjects: Arthritis; Biopsy; Kidney diseases; Laboratories; Lupus; Mental health; Patient Reported Outcomes; Quality of life; Regression analysis
• ISSN: 2053-8790
• DOI: 10.1136/lupus-2022-lupus21century.101

BackgroundLupus nephritis can occur as an isolated component of disease activity or be accompanied by diverse extrarenal symptoms that can adversely affect a patient’s quality of life (QOL). Whether renal disease absent other activity is sufficient to decrease QOL is unknown. A lack of reported QOL impairment may place patients at risk for delayed diagnosis of nephritis or medication noncompliance yet nephritis trials have largely neglected QOL. As such, this study leveraged the multi-center multi-racial Accelerating Medicines Partnership (AMP) lupus nephritis cohort to assess QOL measured by PROMIS-29.MethodsPatients (n=182) fulfilling ACR or SLICC criteria for SLE with a uPCR > .5 and biopsy Class III, IV, V, or mixed were consecutively enrolled in AMP at the time of renal biopsy and clinical history, PROMIS-29, and disease activity as assessed by the hybrid SELENA-SLEDAI were recorded. Patients were determined to have extrarenal clinical activity if, after excluding all laboratory parameters from the SLEDAI, the score remained > 1. Raw PROMIS-29 scores were transformed to t-scores with the mean of 50 + 10 representing the US population and a difference of 5 points considered clinically meaningful. PROMIS-29 physical and mental health summary scores were calculated according to published formulas.ResultsForty-three percent of patients (n=78) had extrarenal clinical manifestations including vasculitis (4%), arthritis (39%), rash (45%), alopecia (42%), mucosal ulcers (13%), pleurisy (12%), pericarditis (8%), and fever (4%). Patients with isolated renal disease (n=104, 57%) did not have PROMIS-29 scores that differed clinically from the US population whereas patients with extrarenal disease reported deficits in physical functioning, fatigue, social functioning, and pain (table 1). Patients with extrarenal disease had significantly lower physical health summary scores compared to patients with isolated disease (median [IQR]: 40.31 [35.79, 47.02] p