PT7:08 Longitudinal association between LLDAS and remission attainment and improvement in health-related quality of life in patients with systemic lupus erythematosus:a multinational prospective cohort study

Objectives Attainment of validated treat-to-target (T2T) endpoints in systemic lupus erythematosus (SLE), such as lupus low disease activity state (LLDAS) and remission, has been shown to improve health-related quality of life (HRQoL) in many observational studies; however, evidence from prospective, longitudinal studies remains limited. We investigated the association between attainment of these T2T endpoints and HRQoL over time utilising a large multinational prospective longitudinal cohort.Methods Data from the Asia Pacific Lupus Collaboration (APLC), collected between 2013 and 2020, were analysed. HRQoL was evaluated using the SF-36v2 surveys, generating physical and mental component summary (PCS and MCS) scores and eight domain-specific scores (physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT). social functioning (SF), role emotional (RE), and mental health (MH)). Longitudinal associations between LLDAS, DORIS remission (REM), and glucocorticoid-free remission (REM-GC0) were examined using multivariable linear mixed-effects models (LMM), and results are reported as regression coefficients (RC) with 95% confidence intervals (CI).Results In total, 2,593 patients from ten countries were studied over a median study period of 3.4 years (IQR 1.3-6.1) (32,951 visits). LLDAS was attained by 84% (n=2,169), REM by 69% (n=1,783), and REM-GC0 by 27·4% (n=702) on at least one occasion. For each T2T state, patients who attained them had significantly better PCS and MCS scores when compared to those did not ( figure 1). Both PCS and MCS scores were higher with deeper and more sustained T2T states, with the magnitude of RC increasing stepwise from LLDAS through REM and REM-GC0, and across durations of sustained attainment, especially in relation to MCS (table 1). Sustained REM-GC0 >12months had the largest impact on PCS and MCS scores. Patients in REM/REM-GC0 also had significantly higher overall mean scores across all 8 domains, whereas those in LLDAS showed significant improvements in seven domains, excluding mental health.Abstract PT7:08 Table 1Longitudinal associations of treat-to-target (T2T) states with overall mean physical component summary (PCS) and mental component summary (MCS) scores: estimates from multivariable linear mixed effect modelsAbstract PT7:08 Figure 1Comparison of covariate-adjusted mean physical component summary (PCS) and mental component summary (MCS) scores by treat-to-target achievement at annual visits. Estimates derived from multivariable linear mixed-effects models, accounting for age at visit, gender, country, flare at visit, and SDI score at visit. *p-value