Evidence map›Paper›PMID 41057213›Full record

ArticleLupus science & medicine2025

Predictors of patient-reported outcomes phenotypes in SLE during remission: a cluster analysis approach.

Elena Elefante, Francy Cruz-Sanabria, Luca Gualtieri, Chiara Stagnaro, Dina Zucchi, Chiara Cardelli, Viola Signorini, Linda Carli, Francesco Ferro, Chiara Tani and 1 more

Abstract read
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Article in Lupus science & medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Elena Elefante *Rheumatology Unit, University of Pisa, Pisa, Italy.ORCID 0000-0003-0657-485X
Francy Cruz-Sanabria *Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Foundation Stella Maris, Pisa, Italy.
Luca GualtieriRheumatology Unit, University of Pisa, Pisa, Italy.
Chiara StagnaroRheumatology Unit, University of Pisa, Pisa, Italy.
Dina ZucchiRheumatology Unit, University of Pisa, Pisa, Italy.ORCID 0000-0002-2161-2562
Chiara CardelliRheumatology Unit, University of Pisa, Pisa, Italy.ORCID 0000-0001-6407-6213
Viola SignoriniRheumatology Unit, University of Pisa, Pisa, Italy.
Linda CarliRheumatology Unit, University of Pisa, Pisa, Italy.
Francesco FerroRheumatology Unit, University of Pisa, Pisa, Italy.
Chiara TaniRheumatology Unit, University of Pisa, Pisa, Italy.
Marta MoscaRheumatology Unit, University of Pisa, Pisa, Italy marta.mosca@unipi.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo identify different clusters of SLE patients in remission based on patient-reported outcomes (PROs) and clinical factors that predict cluster membership.

methodsA cross-sectional monocentric study of adult consecutive SLE outpatients in stable clinical remission. Clinical and laboratory data were collected. At enrolment, each patient completed PROs. A hierarchical clustering analysis based on PROs exploring fatigue (Functional Assessment of Chronic Illness Therapy), disease impact (Lupus Impact Tracker), mental and physical health (mental component summary and physical component summary of the Short Form 36) was performed. Logistic regression assessed predictors of cluster membership, adjusting for demographic and clinical variables.

results195 SLE patients were enrolled. Two distinct clusters emerged: a 'low symptom burden (LSB)' cluster, including 81/195 (41.5%) patients, and a 'high symptom burden (HSB)' cluster, including 114/195 (58.5%) patients. The HSB was characterised by worse scores in all PROs compared with the LSB. The HSB cluster exhibited older age at diagnosis (33.23±11.97 vs 27.75±11.57; p=0.002), less frequent previous renal involvement (33.3% vs 65.4%; p<0.001), more frequent previous neuropsychiatric lupus (17.2% vs 1.3%; p=0.001), more fibromyalgia (26.3% vs 5.3%; p=0.001) and ongoing glucocorticoid use (58.8% vs 37.0%; p=0.004). Fibromyalgia (OR 7.27, 95% CI 2.27 to 29.15, p=0.002) and glucocorticoid treatment (OR 3.05, 95% CI 1.43 to 6.77, p=0.005) were independently associated with higher likelihood of HSB membership; renal involvement was associated with LSB membership (OR 0.23, 95% CI 0.10 to 0.51, p≤0.001).

conclusionsAmong SLE patients in remission, two distinct health-related quality of life phenotypes can be identified: an HSB and an LSB. Fibromyalgia and glucocorticoid treatment emerged as independent predictors of HSB. These findings underline the need to optimise disease management and align treatment goals with patient priorities.

Indexed as

Lupus Erythematosus, SystemicPatient Reported Outcome MeasuresAdultCluster AnalysisCross-Sectional StudiesFatigueFemaleHumansLogistic ModelsMaleMiddle AgedPhenotypeQuality of LifeRemission InductionYoung AdultHealth-Related Quality Of LifeLupus Erythematosus, SystemicPatient Reported Outcome Measures

Identifiers

PMID41057213
PMCPMC12506475

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