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Fibromyalgia is a major contributor to quality of life in lupus
Authors:DD Gladman  MB Urowitz  J Gough  A MacKinnon
Affiliation:University of Toronto Lupus Clinic, Centre for Prognosis Studies in The Rheumatic Diseases, The Toronto Hospital, Ontario, Canada.
Abstract:OBJECTIVE; To determine whether individual variables of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus International Coordinating Committee/American College of Rheumatology (SLICC/ACR) Damage Index were associated with any of the domains of the Short Form 36 (SF-36) quality of life measure, and to assess the contribution of fibromyalgia (FM) to the quality of life measure. METHODS: Patients with systemic lupus erythematosus (SLE) seen between December 1994 and May 1995 completed SF-36 questionnaires at the time of their clinical evaluations at the Lupus Clinic. Disease activity was measured by SLEDAI, damage was assessed by the SLICC/ACR Damage Index, and FM was diagnosed in the presence of widespread pain and > or = 11 of 18 FM tender points. The components of SLEDAI and the Damage Index were compared to the domains of the SF-36 using Pearson correlation coefficients. A t test was used to compare the variables in patients with and without FM. RESULTS: One hundred nineteen patients with SLE participated in the study. Presence of FM, which occurred in 21% of the patients, was not related to either the overall scores or any of the components of SLEDAI or Damage Index, but was highly correlated with all 8 domains of the SF-36. The correlations ranged from -0.26 to -0.43, with associated p values of 0.007 to 0.0001. CONCLUSION: In a cross sectional study of patients with SLE at one point in time the SF-36 reflected the presence of FM rather than disease activity or damage.
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