EQ-5D and SF-36 Quality of Life Measures in Systemic Lupus Erythematosus: Comparisons with Rheumatoid Arthritis, Noninflammatory Rheumatic Disorders, and Fibromyalgia

• Published in: Journal of rheumatology 2010-02, Vol.37 (2), p.296-304
• Main Authors: WOLFE, Frederick, MICHAUD, Kaleb, LI, Tracy, KATZ, Robert S
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adult; Aged; Biological and medical sciences; Databases, Factual; Diseases of the osteoarticular system; Female; Health Status; Health Surveys; Humans; Inflammatory joint diseases; Lupus Erythematosus, Systemic - physiopathology; Lupus Erythematosus, Systemic - psychology; Male; Medical sciences; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Quality of Life - psychology; Rheumatic Diseases - physiopathology; Rheumatic Diseases - psychology; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Severity of Illness Index; Surveys and Questionnaires
• ISSN: 0315-162X; 1499-2752
• DOI: 10.3899/jrheum.090778

Objective. The Medical Outcomes Study Short-form 36 (SF-36) provides numerical measurement of patient health, but does not include preferences for health states and cannot be used directly in cost-effectiveness analyses. By contrast the Euroqol EQ-5D can be used for cost-effectiveness analyses. The EQ-5D has rarely been used in systemic lupus erythematosus (SLE). We compared SF-36 and EQ-5D values across rheumatic diseases. Methods. We studied 1316 patients with SLE, 13,722 with rheumatoid arthritis (RA), 3623 with non-inflammatory rheumatic disorders (NIRD), and 2733 with fibromyalgia (FM). Results. The mean EQ-5D, physical (PCS) and mental (MCS) component summary scores were 0.72, 36.3, and 44.3, respectively, in SLE. There was essentially no difference among EQ-5D and PCS scores for patients with SLE, RA, or NIRD. MCS was lower in SLE compared with RA and NIRD (44.3, 49.1, 50.8, respectively). All scores were more abnormal in FM (0.61, 31.9, 41.9). Within SF-36 domains, physical function was better, but general health, vitality, social function, role-emotional, and mental health were more impaired in SLE compared with RA and NIRD. In SLE, quality of life (QOL) was predicted by damage, comorbidity, income, education, and age. Fifteen percent of patients with SLE were very satisfied with their health, and their QOL scores (0.84, 45.4, 50.1) were similar to those found in the US population for EQ-5D and MCS, but were slightly reduced for PCS. Conclusion. EQ-5D and PCS are at the same levels in SLE as in RA and NIRD, but are more abnormal in SLE in the MCS and mental health domains. EQ-5D values allow preference-based comparisons with other chronic conditions.