Characteristics of Polish patients with systemic lupus erythematosus obtained from SESAME registry. Activity of the disease, degree of impairment, and availability of social care
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Submission date: 2013-05-22
Final revision date: 2013-08-14
Acceptance date: 2013-09-10
Online publication date: 2013-10-31
Publication date: 2013-10-30
Reumatologia 2013;51(5):332-341
The aim of the study was to characterize a large, and as homogeneous as possible, group of Polish patients with systemic lupus erythematosus (SLE). We focused on the sociodemographic characteristics of this group, clinical status at enrollment, and access to healthcare resources.
Material and methods: The study included 269 consecutive patients from six Polish centers for rheumatology, in Bialystok, Katowice, Lublin, Poznań, Warsaw, and Wroclaw, qualified for the international multicenter study SESAME.
Results: The majority of participants were women (n = 234; 87%). Only 28.6% of SLE patients were employed full-time, and about one third of them received disability pension. The studied group included 12% of patients with at least a 6-point SELENA SLEDAI score, who showed a decreased level of complement and tested positively for anti-dsDNA antibodies. Patients whose SELENA SLEDAI scores exceeded 10 points (42%) showed the active involvement of all systems and organs included in the SLE Activity Index, except for skin and mucosal membranes, with a significantly greater frequency than the other groups. The involvement of the musculoskeletal system was also significantly more frequent in patients with SELENA SLEDAI scores between 6 and 10 points (30.5%). We observed a significant association between the activity of the disease and the prevalence of disability or having the support of a social worker.
Conclusions: The population of Polish patients with SLE includes a group of individuals who, due to high activity of the disease confirmed both by physical examination and additional testing, require intensification of the therapeutic protocol. This group can be identified on the basis of the SELENA SLEDAI score. Also, patients with severe disability are characterized by higher activity of the disease. It cannot be excluded that optimal therapeutic control of SLE activity in this group could be reflected by diminished demand for social care services and by a higher level of health-related quality of life.
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