The association between duration of remission, fatigue, depression and health-related quality of life in Italian patients with systemic lupus erythematosus

Objective To evaluate the impact of duration of remission on the health-related quality of life (HRQoL) of patients with systemic lupus erythematosus (SLE). Methods We conducted a 5-year retrospective study on two Italian cohorts. Remission was defined as a continuative period of no clinical disease activity, according to the Systemic Lupus Erythematosus Disease Activity Index 2 K, and a permitted maximum prednisone dose of 5 mg/day. HRQoL was measured using the 36-Item Short-Form Health Survey (SF36) during the last visit. Results We enrolled 136 female SLE patients. During observation, 15 (11%) patients had been in remission for >= 1 and <2 years, 15 (11%) for >= 2 and <3 years, 19 (14%) for >= 3 and <4 years, 9 (7%) for >= 4 and <5 years, and 53 (39%) had been in prolonged remission for >= 5 years. In the multivariate model, considering depression and fatigue as covariates, patients in prolonged remission showed significantly better scores in the physical functioning (p = 0.039), role physical (p = 0.029), bodily pain (p = 0.0057), general health (p = 0.0033) and social functioning (p = 0.0085) components of the SF36, compared with those in remission Conclusion Lupus remission could improve the HRQoL of SLE patients, particularly when associated with appropriate management of depression and fatigue.