Open AccessLimitations of current treatments for systemic lupus erythematosus: a patient and physician survey
Author(s) -
Vibeke Strand,
C. Galateanu,
D.S. Pushparajah,
Enkeleida Nikaï,
Jennifer Sayers,
Robert Wood,
R. van Vollenhoven
Publication year - 2013
Publication title -
lupus
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.069
H-Index - 103
eISSN - 1477-0962
pISSN - 0961-2033
DOI - 10.1177/0961203313492577
Subject(s) - medicine , quality of life (healthcare) , work productivity , disease , physical therapy , productivity , nursing , economics , macroeconomics
An independent cross-sectional survey assessed systemic lupus erythematosus (SLE) disease and treatment burden. Variables included medication classes prescribed, disease activity, flare occurrences, treatment satisfaction, and validated measures of health-related quality of life (HRQoL), fatigue and work productivity. Of 886 eligible patients (mean age 41.3 years, 89% female), 515 completed the survey. One-third reported moderate-to-severe disease activity, and 31% had flared in the last 12 months. Higher severity of disease activity (moderate-to-severe) was associated with ≥2 medication classes prescribed and treatment regimens that included corticosteroids (CS) (both p < 0.0001). Patients receiving CS reported lower EQ-5D scores ( p = 0.0019) and higher fatigue levels ( p < 0.001), and both patients ( p = 0.0019) and physicians ( p = 0.0001) were less likely to report satisfaction with treatment regimens including CS. Among responders eligible for work ( n = 456), severity of disease activity (moderate-to-severe vs. mild) was associated with unemployment (52.9% vs. 40.8%; p = 0.0189), greater impairment in work productivity (36% vs. 21%; p = 0.0003) and participation in daily activities (41% vs. 21%; p < 0.0001). This survey confirms that SLE and current treatment options substantially impair patients' health status and work productivity. Physician- and patient-reported satisfaction with current treatment regimens, despite poorly controlled disease activity, indicate they are resigned to the limitations of available SLE treatment regimens.