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IDENTIFYING DETERMINANTS OF FAVOURABLE AND POOR PHYSICAL FUNCTION IN SYSTEMIC LUPUS ERYTHEMATOSUS : RESULTS FROM AN INTERNATIONAL COLLABORATIVE STUDY

Lee, S. Y. (författare)
King’s College Hospital, Rheumatology Department, London, United Kingdom
Holloway, A. (författare)
King’s College Hospital, Rheumatology Department, London, United Kingdom
Nikiphorou, E. (författare)
King’s College Hospital, Rheumatology Department, London, United Kingdom; King’s College London, Centre for Rheumatic Diseases, London, United Kingdom
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Parodis, Ioannis, 1981- (författare)
Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Örebro University, Department of Rheumatology, Faculty of Medicine and Health, Sweden, Sweden; Karolinska Institutet and Karolinska University Hospital, Division of Rheumatology, Department of Medicine Solna, Stockholm, Sweden
Ravichandran, N. (författare)
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Clinical Immunology and Rheumatology, Lucknow, India
Day, J. (författare)
The Royal Melbourne Hospital, Department of Rheumatology, Parkville, Australia; University of Melbourne, Department of Medical Biology, Parkville, Australia; WEHI - Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
Joshi, M. (författare)
Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India
Saha, S. (författare)
Mymensingh Medical College, Mymensingh, Bangladesh
Jagtap, K. (författare)
Seth Gordhandhas Sunderdas Medical College and King Edwards Memorial Hospital, Mumbai, Maharashtra, India
Katchamart, W. (författare)
Faculty of Medicine Siriraj Hospital, Mahidol University, Division of Rheumatology, Department of Medicine, Bangkok, Thailand
Goo, P. A. (författare)
Queen Savang Vadhana Memorial Hospital, Department of Medicine, Chonburi, Thailand
Vaidya, B. (författare)
National Center for Rheumatic Diseases (NCRD), Ratopul, Kathmandu, Nepal
Velikova, T. (författare)
Sofia University St. Kliment Ohridski, Medical Faculty, Sofia, Bulgaria
Sen, P. (författare)
Maulana Azad Medical College, New Delhi, India
Katsuyuki Shinjo, S. (författare)
Universidade de Sao Paulo, Division of Rheumatology, Faculdade de Medicina FMUSP, Sao Paulo, Brazil
Agarwal, V. (författare)
Mahatma Gandhi Mission Medical College, Navi Mumbai, Maharashtra, India
Tan, A. L. (författare)
Leeds Teaching Hospitals Trust, NIHR Leeds Biomedical Research Centre, Leeds, United Kingdom; University of Leeds, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, United Kingdom
Ziade, N. (författare)
Saint-Joseph University, Rheumatology, Beirut, Lebanon; Hotel-Dieu de France Hospital, Rheumatology, Beirut, Lebanon
Milchert, M. (författare)
Pomeranian Medical University in Szczecin, Department of Internal Medicine, Rheumatology, Diabetology, Geriatrics and Clinical Immunology, Szczecin, Poland
Gracia-Ramos, A. E. (författare)
National Medical Center “La Raza”, Instituto Mexicano del Seguro Social, Department of Internal Medicine, Mexico City, Mexico
Vinicio Caballero, C. (författare)
Hospital Universidad del Norte, Department of Medicine, Barranquilla, Atlantico, Colombia
Chinoy, H. (författare)
Manchester Academic Health Science Centre, The University of Manchester, Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester, United Kingdom; Manchester University NHS Foundation Trust, The University of Manchester, National Institute for Health Research Manchester Biomedical Research Centre, Manchester, United Kingdom; Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Department of Rheumatology, Salford, United Kingdom
Aggarwal, R. (författare)
University of Pittsburgh School of Medicine, Division of Rheumatology and Clinical Immunology, Pennsylvania, United States of America
Gupta, L. (författare)
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Clinical Immunology and Rheumatology, Lucknow, India; Manchester Academic Health Science Centre, The University of Manchester, Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester, United Kingdom; Royal Wolverhampton Hospitals NHS Trust, Department of Rheumatology, Wolverhampton, United Kingdom; City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
Wincup, C. (författare)
Rayne Institute, University College London, Department of Rheumatology, Division of Medicine, London, United Kingdom; UCLH, GOSH, Centre for Adolescent Rheumatology Versus Arthritis at UCL, London, United Kingdom
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 (creator_code:org_t)
HighWire Press, 2023
2023
Engelska.
Ingår i: Annals of the Rheumatic Diseases. - : HighWire Press. - 0003-4967 .- 1468-2060. ; 82:Suppl. 1, s. 1110-1112
Relaterad länk:
https://doi.org/10.1...
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https://urn.kb.se/re...
https://doi.org/10.1...
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  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
Abstract Ämnesord
Stäng  
  • Background: Systemic lupus erythematosus (SLE) can result in impaired daily physical function through various mechanisms including active disease, chronic damage, and mental health symptoms that are common in the disease. However, the key drivers of reduced physical function are poorly understood, and no large-scale global studies investigating this have been conducted to date.Objectives: To investigate key factors that contribute to impaired physical function in SLE globally.Methods: SLE patients were identified from the COVAD 2 database, a global register of more than 20,000 respondents. Healthy controls (HC) were included to compare differences in physical function using the Patient Reported Outcome Measurement Information System (PROMIS) questionnaire. Demographics, medication, comorbidities, disease activity, Global Physical Health (GPH) and Global Mental Health (GMH) were collected. Multivariable regression analysis was used to identify contributing factors to favourable or poor physical function (measured by PROMIS Physical Function shortform PF-10a score).Results: 979 SLE patients and 3358 HCs were included in analysis. Patients with SLE had significantly lower PF-10a score as compared to HCs (median 42, IQR 36-47 vs median 49, IQR 45-50, p<0.0001). Determinants of physical function status in patients with SLE are summarised in Table 1. Briefly, factors associated with poor physical function included increasing age (-0.042, 95% CI -0.069 to -0.015, p=0.002) and methotrexate use (-0.928, 95% CI -1.844 to -0.012, p=0.047). Diabetes (-1.862, 95% CI -3.481 to -0.243, p=0.024) and interstitial lung disease (ILD) (-2.441, 95% CI -4.366 to -0.517, p=0.013), but not asthma or COPD, also contributed to lower PF-10a score. From a mental health perspective, anxiety (-0.970, 95% CI -1.853 to -0.087, p=0.031) but not depression contributed to a lower physical function score. Higher Pain Visual Analogue Scales (VAS) (-2.889, 95% CI -3.107 to -2.671, p<0.001) and Fatigue VAS (-1.459, 95% CI -1.974 to -0.945, p<0.001) also contributed to lower PF-10 scores. Hydroxychloroquine use (0.844, 95% CI 0.190 to 1.498, p=0.012) and higher GPH score (2.287, 95% CI 2.079 to 2.494, p<0.001) were associated with favourable physical function.Conclusion: Patients with SLE show significantly reduced physical function compared with HCs. Key contributors to poor physical function include intercurrent diabetes and ILD. Screening for, and aggressive early treatment of these conditions may confer improved long-term function. As expected, higher levels of pain and fatigue were associated with poor physical function. Methotrexate use was also identified as a contributing factor to reduced function, which could represent its use in articular manifestations that limit physical function. Importantly, use of hydroxychloroquine was associated with favourable physical function, adding to the well-recognised benefits of this drug in SLE.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)

Nyckelord

Systemic lupus erythematosus
Comorbidities

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