TY - JOUR
T1 - Outcome clusters and their stability over 1 year in patients with SLE
T2 - self-reported and performance-based cognitive function, disease activity, mood and health-related quality of life
AU - Gupta, Ambika
AU - Johnson, Sindhu
AU - Barraclough, Michelle
AU - Su, Jiandong
AU - Bingham, Kathleen
AU - Knight, Andrea M
AU - Diaz Martinez, Juan Pablo
AU - Kakvan, Mahta
AU - Tartaglia, Maria Carmela
AU - Ruttan, Lesley
AU - Marzouk, Sherief
AU - Wither, Joan
AU - Choi, May
AU - Bonilla, Dennisse
AU - Appenzeller, Simone
AU - Beaton, Dorcas
AU - Katz, Patricia
AU - Green, Robin
AU - Touma, Zahi
N1 - © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2024/7/11
Y1 - 2024/7/11
N2 - OBJECTIVE: To determine if self-reported fatigue, anxiety, depression, cognitive difficulties, health-related quality of life, disease activity scores and neuropsychological battery (NB) cluster into distinct groups in patients with SLE based on symptom intensity and if they change at 1-year follow-up.METHODS: This is a retrospective analysis of consecutive consenting patients, followed at a single centre. Patients completed a comprehensive NB, the Beck Anxiety Inventory, Beck Depression Inventory, Fatigue Severity Scale, Short-Form Health Survey Physical Component Summary and Mental Component Summary scores and the Perceived Deficits Questionnaire. Disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index 2000. Ward's method was used for clustering and principal component analysis was used to visualise the number of clusters. Stability at 1 year was assessed with kappa statistic.RESULTS: Among 142 patients, three clusters were found: cluster 1 had mild symptom intensity, cluster 2 had moderate symptom intensity and cluster 3 had severe symptom intensity. At 1-year follow-up, 49% of patients remained in their baseline cluster. The mild cluster had the highest stability (77% of patients stayed in the same cluster), followed by the severe cluster (51%), and moderate cluster had the lowest stability (3%). A minority of patients from mild cluster moved to severe cluster (19%). In severe cluster, a larger number moved to moderate cluster (40%) and fewer to mild cluster (9%).CONCLUSION: Three distinct clusters of symptom intensity were documented in patients with SLE in association with cognitive function. There was a lower tendency for patients in the mild and severe clusters to move but not moderate cluster over the course of a year. This may demonstrate an opportunity for intervention to have moderate cluster patients move to mild cluster instead of moving to severe cluster. Further studies are necessary to assess factors that affect movement into moderate cluster.
AB - OBJECTIVE: To determine if self-reported fatigue, anxiety, depression, cognitive difficulties, health-related quality of life, disease activity scores and neuropsychological battery (NB) cluster into distinct groups in patients with SLE based on symptom intensity and if they change at 1-year follow-up.METHODS: This is a retrospective analysis of consecutive consenting patients, followed at a single centre. Patients completed a comprehensive NB, the Beck Anxiety Inventory, Beck Depression Inventory, Fatigue Severity Scale, Short-Form Health Survey Physical Component Summary and Mental Component Summary scores and the Perceived Deficits Questionnaire. Disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index 2000. Ward's method was used for clustering and principal component analysis was used to visualise the number of clusters. Stability at 1 year was assessed with kappa statistic.RESULTS: Among 142 patients, three clusters were found: cluster 1 had mild symptom intensity, cluster 2 had moderate symptom intensity and cluster 3 had severe symptom intensity. At 1-year follow-up, 49% of patients remained in their baseline cluster. The mild cluster had the highest stability (77% of patients stayed in the same cluster), followed by the severe cluster (51%), and moderate cluster had the lowest stability (3%). A minority of patients from mild cluster moved to severe cluster (19%). In severe cluster, a larger number moved to moderate cluster (40%) and fewer to mild cluster (9%).CONCLUSION: Three distinct clusters of symptom intensity were documented in patients with SLE in association with cognitive function. There was a lower tendency for patients in the mild and severe clusters to move but not moderate cluster over the course of a year. This may demonstrate an opportunity for intervention to have moderate cluster patients move to mild cluster instead of moving to severe cluster. Further studies are necessary to assess factors that affect movement into moderate cluster.
KW - Humans
KW - Female
KW - Male
KW - Quality of Life/psychology
KW - Adult
KW - Lupus Erythematosus, Systemic/psychology
KW - Middle Aged
KW - Self Report
KW - Retrospective Studies
KW - Cognition/physiology
KW - Severity of Illness Index
KW - Cluster Analysis
KW - Fatigue/psychology
KW - Depression/epidemiology
KW - Affect
KW - Anxiety/epidemiology
KW - Neuropsychological Tests/statistics & numerical data
KW - Follow-Up Studies
KW - Surveys and Questionnaires
UR - http://www.scopus.com/inward/record.url?scp=85198730292&partnerID=8YFLogxK
U2 - 10.1136/lupus-2023-001006
DO - 10.1136/lupus-2023-001006
M3 - Article
C2 - 38991833
SN - 2053-8790
VL - 11
JO - Lupus Science & Medicine
JF - Lupus Science & Medicine
IS - 2
M1 - e001006
ER -