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ABSTRACT: Background
While survival of systemic lupus erythematosus (SLE) patients has improved substantially, problems remain in the management of their emotional health. Medium to high-dose glucocorticoid doses are known to worsen emotional health; the effect is unclear among patients receiving relatively low-dose glucocorticoids. This study aims to investigate the association between low glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS).Methods
This cross-sectional study drew on data from SLE patients in 10 Japanese institutions. The participants were adult patients with SLE duration of ??1?year who met LLDAS criteria at the study visit from April 2018 through September 2019. The exposure was the daily glucocorticoid dose (mg oral prednisolone). The outcome was the emotional health score of the lupus patient-reported outcome scale (range: 0 to 100). Multiple linear regression analysis was performed with adjustment for confounders including disease-related damage, activity, and psychotropic drug use.Results
Of 192 patients enrolled, 175 were included in the analysis. Their characteristics were as follows: female, 89.7%; median age, 47?years (interquartile range (IQR): 37.0, 61.0). Median glucocorticoid dose was 4.0?mg (IQR 2.0, 5.0), and median emotional health score 79.2 (IQR 58.3, 91.7). Multiple linear regression analysis showed daily glucocorticoid doses to be associated with worse emotional health (? coefficient?=?-?2.54 [95% confidence interval?-?4.48 to -?0.60], P?=?0.01).Conclusions
Daily glucocorticoid doses were inversely associated with emotional health among SLE patients in LLDAS. Further studies are needed to determine whether glucocorticoid tapering leads to clinically significant improvements in emotional health.
SUBMITTER: Miyawaki Y
PROVIDER: S-EPMC7944592 | biostudies-literature | 2021 Mar
REPOSITORIES: biostudies-literature
Miyawaki Yoshia Y Shimizu Sayaka S Ogawa Yusuke Y Sada Ken-Ei KE Katayama Yu Y Asano Yosuke Y Hayashi Keigo K Yamamura Yuriko Y Hiramatsu-Asano Sumie S Ohashi Keiji K Morishita Michiko M Watanabe Haruki H Takano-Narazaki Mariko M Matsumoto Yoshinori Y Yajima Nobuyuki N Yoshimi Ryusuke R Shimojima Yasuhiro Y Ohno Shigeru S Kajiyama Hiroshi H Ichinose Kunihiro K Sato Shuzo S Fujiwara Michio M Yamazaki Hajime H Yamamoto Yosuke Y Wada Jun J Fukuhara Shunichi S
Arthritis research & therapy 20210310 1
<h4>Background</h4>While survival of systemic lupus erythematosus (SLE) patients has improved substantially, problems remain in the management of their emotional health. Medium to high-dose glucocorticoid doses are known to worsen emotional health; the effect is unclear among patients receiving relatively low-dose glucocorticoids. This study aims to investigate the association between low glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS).<h4>Methods</h4>This c ...[more]