Rheumatology ·
SLE remission associated with patient-acceptable symptom state in Spanish cohort
A multicenter registry analysis of 1,249 people with systemic lupus erythematosus (SLE) examined patient-reported acceptable symptom state (PASS) in relation to disease activity and other factors. Lower disease activity and meeting DORIS remission or LLDAS criteria were associated with PASS, while pain, fatigue-related limitations and anxiety were important barriers.
- 72% of 1,249 participants reported PASS.
- DORIS remission and LLDAS were associated with PASS.
- Pain, fatigue limitations and anxiety were key barriers.
- One in five patients in remission did not report PASS.
Researchers analyzed data from the Spanish multicenter RELESSER SLE registry to assess associations between patient-reported PASS and disease activity measured by SLEDAI-2K, DORIS remission and lupus low disease activity state (LLDAS). The analysis also considered demographic and clinical factors, therapies, organ damage and Lupus Impact Tracker responses, using univariable and multivariable logistic regression. PASS was reported by 72% of participants (n=1,249).
Lower SLEDAI-2K scores, DORIS remission and LLDAS were independently associated with PASS. Higher education and employment were positively associated; female sex and fibromyalgia were negatively associated. When Lupus Impact Tracker items were included, pain, fatigue-related limitations and anxiety showed the strongest associations. Among participants in DORIS remission, 20% did not report PASS; female sex, fibromyalgia, pain, fatigue-related limitations and anxiety remained independent barriers. These observational associations suggest that remission alone may not capture patients’ perceived health and that symptom burden may represent unmet needs. The findings do not establish causation or show that a particular intervention improves PASS.
In practice
For people with SLE, achieving DORIS remission or LLDAS was associated with reporting an acceptable symptom state, but remission did not ensure satisfactory patient-perceived health: one in five participants in DORIS remission was not in PASS. Pain, fatigue-related limitations and anxiety remained associated with not reaching PASS. These findings support considering patient-reported health and persistent symptoms alongside disease activity when assessing unmet needs; the registry analysis is observational and does not show that any specific intervention will improve these outcomes.
AI-generated clinical interpretation · Not editor-reviewed
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Arthritis Care & Research: Disease activity and patient‐perceived health: associations with the Patient Acceptable Symptom State (PASS) in a large multicenter systemic lupus erythematosus cohort ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.