Objective To evaluate the association between the daily GC dose and various patient-reported outcomes (PROs) in patients who have achieved lupus low disease activity state (LLDAS). Methods Patients from a single-center cohort were included. PROs included were the FACIT-F (Functional Assessment of Chronic Illness Therapy-Fatigue), the LupusQoL (Lupus Quality of Life), the physical and mental component summary measures of the SF-36 (36-Item Short Form Health Survey) and the LFA-REAL PRO (Lupus Foundation of America Rapid Evaluation of Activity in Lupus PRO). Univariable and multivariable generalized estimating equations (GEE) were performed; the multivariable models were adjusted for possible confounders: age at diagnosis, sex, socioeconomic status, educational level, ethnicity, disease duration, disease activity and damage, antimalarial and immunosuppressant use. In an alternative analysis, GEE were also performed with patients categorized on the basis of 4 prednisone dose categories: 0mg, >0mg & ≤2.5mg, >2.5mg & ≤5mg and >5mg & ≤7.5mg. Results Three-hundred and twenty-four patients and 1338 LLDAS visits were included. In the adjusted analysis, the daily GC dose was associated with worse FACIT-F, LFA-REAL PRO and four out of the eight domains of the LupusQoL scores. In the alternative analysis, after adjustment, the patients in the high GC dose category had a trend of worse PRO scores in the adjusted analysis and the ones in the lower GC dose category showed a trend of better PRO scores. Conclusion The daily GC dose is associated with worse PROs in SLE patients on LLDAS, even after adjusting for possible confounders
Singh et al. (Sun,) studied this question.