Quality of life in systemic lupus erythematosus: description in a cohort of French patients and association with blood hydroxychloroquine levels

M Jolly; L Galicier; O Aumaître; C Francès; V Le Guern; F Lioté; A Smail; N Limal; L Perard; H Desmurs-Clavel; D L T H Boutin; B Asli; J-E Kahn; J Pourrat; L Sailler; F Ackermann; T Papo; K Sacré; O Fain; J Stirnemann; P Cacoub; M Jallouli; G Leroux; J Cohen-Bittan; J-S Hulot; S Arora; Z Amoura; J-C Piette; N Costedoat-Chalumeau; PLUS group

doi:10.1177/0961203315627200

Quality of life in systemic lupus erythematosus: description in a cohort of French patients and association with blood hydroxychloroquine levels

Lupus. 2016 Jun;25(7):735-40. doi: 10.1177/0961203315627200. Epub 2016 Feb 13.

Authors

M Jolly¹, L Galicier², O Aumaître³, C Francès⁴, V Le Guern⁵, F Lioté⁶, A Smail⁷, N Limal⁸, L Perard⁹, H Desmurs-Clavel⁹, D L T H Boutin¹⁰, B Asli², J-E Kahn¹¹, J Pourrat¹², L Sailler¹³, F Ackermann¹¹, T Papo¹⁴, K Sacré¹⁴, O Fain¹⁵, J Stirnemann¹⁶, P Cacoub¹⁷, M Jallouli⁵, G Leroux¹⁰, J Cohen-Bittan¹⁸, J-S Hulot¹⁹, S Arora²⁰, Z Amoura¹⁰, J-C Piette¹⁰, N Costedoat-Chalumeau⁵; PLUS group

Affiliations

¹ Rush University Medical Center, Chicago, IL, USA Meenakshi_Jolly@rush.edu nathalie.costedoat@gmail.com.
² Université Paris Diderot, Sorbonne Paris-Cité and AP-HP, Hôpital Saint Louis, service d'immunologie clinique, Paris, France.
³ Université de Clermont-Ferrand and CHU Clermont-Ferrand, Hôpital Gabriel Montpied, service de médecine interne, Clermont-Ferrand, France.
⁴ UPMC, Université Paris 6 and AP-HP, Hôpital Tenon, service de dermatologie allergologie, Paris, France.
⁵ Université Paris-Decartes and AP-HP, Hôpital Cochin, service de médecine interne, Paris, France.
⁶ Université Paris-Diderot, Sorbonne Paris-Cité and AP-HP, Hôpital Lariboisière, service de rhumatologie, Paris, France.
⁷ CHU Amiens, Hôpital Nord, service de médecine interne, Amiens, France.
⁸ UPEC; AP-HP, Hôpital Henri Mondor, service de médecine interne, Créteil, France.
⁹ Hospices Civils de Lyon, Groupement Hospitalier Edouard Herriot, service de médecine interne, Lyon, France.
¹⁰ UPMC, Université Paris 6 and AP-HP, Hôpital Pitié-Salpêtrière, service de médecine interne, Paris, France.
¹¹ Hôpital Foch, service de médecine interne, Suresnes, France.
¹² Université Paul-Sabatier and CHU Toulouse, Hôpital Rangueil, service de néphrologie, Toulouse, France.
¹³ Université Paul-Sabatier and CHU Toulouse, Hôpital Purpan, service de médecine interne, Toulouse, France.
¹⁴ Université Paris-Diderot, Sorbonne Paris-Cité and AP-HP, Hôpital Bichat Claude-Bernard, service de médecine interne, Paris, France.
¹⁵ Hôpital Saint Antoine, DHU i2B, service de médecine interne, Université Paris 6.
¹⁶ Division of General Internal Medicine, Geneva University Hospital, Geneva, Switzerland.
¹⁷ APHP, Département de Médecine Interne et Immunologie clinique, Groupe Hospitalier Pitié Salpétriére Paris, France; DHU Inflammation, Immunopathologie, Biothérapie, Université Pierre et Marie Curie, Paris VI, France; UMR 7211 (UPMC/CNRS), UMR S-959 (INSERM).
¹⁸ UPMC, Université Paris 6 and AP-HP, Hôpital Pitié-Salpêtrière, service de gériatrie Pr Verny, Paris, France.
¹⁹ Sorbonne Universités, UPMC Univ Paris 06, AP-HP, Institute of Cardiometabolism and Nutrition (ICAN), F-75013, Paris, France.
²⁰ Rush University Medical Center, Chicago, IL, USA.

PMID: 26876692
DOI: 10.1177/0961203315627200

Abstract

Objectives: Benefits of hydroxychloroquine (HCQ) use on physician reported outcomes are well documented in systemic lupus erythematosus (SLE). We assess for the first time the association and predictive value of blood HCQ levels towards health-related quality of life (HRQOL) in SLE.

Methods: Data from the PLUS study (a randomized, double-blind, placebo-controlled, multicentre study) were utilized. Blood HCQ levels were quantified by high-performance liquid chromatography along with HRQOL assessments (Medical Outcomes Study-SF-36) at baseline (V1) and month 7 (V2).

Results: 166 SLE patients' data were analysed. Mean (SD) age and disease duration were 44.4 (10.7) and 9.3 (6.8) years. Eighty-seven per cent were women. Mean (SD, median, IQR) HCQ concentrations in the blood at V1 were 660 (314, 615, 424) ng/ml and increased to 1020 (632, 906, 781) ng/ml at V2 (mean difference 366 units, 95% confidence interval -472 to -260, p < 0.001). No significant correlations between HCQ concentrations with HRQOL domains at V1 or V2 were noted. There were no differences in HRQOL stratified by HCQ concentrations. HCQ concentrations at V1 or changes in HCQ concentration (V2-V1) were not predictive of HRQOL at V2 or changes in HRQOL (V2-V1).

Conclusions: No association of HCQ concentrations with current or longitudinal HRQOL were found in SLE.

Keywords: Hydroxychloroquine; blood concentration; patient reported outcomes; quality of life; systemic lupus erythematosus.

Publication types

Multicenter Study
Randomized Controlled Trial

MeSH terms

Adult
Antirheumatic Agents / blood*
Double-Blind Method
Female
France
Humans
Hydroxychloroquine / blood*
Linear Models
Lupus Erythematosus, Systemic / blood*
Male
Middle Aged
Quality of Life*

Substances

Antirheumatic Agents
Hydroxychloroquine