{
  "abstract": "Objectives To evaluate the association between disease activity and the Patient Acceptable Symptom State (PASS) and to identify clinical and socio-demographic correlates of PASS in systemic lupus erythematosus (SLE).Methods We analyzed data from the large multicenter RELESSER registry (39 Spanish centers). PASS was self-assessed as acceptable (PASS-A) or non-acceptable. Collected variables included socio-demographics (age, sex, employment, educational attainment) fibromyalgia, disease activity (SLEDAI-2K), DORIS-remission (DORIS-R) and LLDAS achievement, disease damage (SLICC/ACR damage index (SDI), current therapies and the Lupus Impact Tracker (LIT) items. Univariable and multivariable logistic regression were performed. Models were run with clinical covariates and LIT items. A sub-analysis was carried-out in patients being in DORIS remission.Results Among 1,249 patients (90% women; mean age 48.2 years), 72% reported being PASS-A. Lower disease activity (SLEDAI-2K OR 0.95, 95% CI 0.92–0.99), DORIS remission (OR 2.48, 95% CI 1.87–3.82) and LLDAS (OR 2.60, 95% CI 1.91–3.54) were associated with higher PASS-A probability. Being employed was positively associated, while female sex, fibromyalgia and current glucocorticoid use were negatively associated with PASS-A. When LIT items were included in de models, SLEDAI-2K lost significance, while DORIS-R (OR 1.49, 95% CI 1.10–2.03) and LLDAS (LLDAS OR 1.84, 95% CI 1.33–2.55) remained associated though attenuated. Pain/aching, limitations due to pain/fatigue, family-role limitations and anxiety were the strongest independent barriers to PASS-A ( table 1). Among the 628 patients in DORIS-R, 20% were not in PASS-A; female sex (OR 0.34, 95% CI 0.12–0.97) and fibromyalgia (OR 0.37, 95% CI 0.17–0.78) remained negative determinants, whereas higher education (OR 2.48, 95% CI 1.56–3.98) and employment (OR 1.90, 95% CI 1.16–3.11) were positively associated with PASS-A. Within this subgroup, pain, fatigue-related limitations and anxiety remained the main barriers to perceiving an acceptable symptom state.Abstract PT7:06 Table 1Assoiation between disease activity state, as measured by SLEDAI-2K, DORIS and LLDAS, and being in PASS acceptable after including fibromyalgia or the LIT items in the modelsConclusions DORIS remission and LLDAS are associated with PASS acceptable response. Pain, fatigue and anxiety prevent many SLE patients from achieving satisfactory health beyond disease remission. 20% of SLE patient in DORIS remission are still not in PASS acceptable. PASS assessment may help revealing unmet needs in SLE management.",
  "authors": [
    {
      "affiliations": [
        "Zuyderland Medical Center, Heerlen-Sittard, The Netherlands"
      ],
      "name": "Cesar Magro-Checa"
    },
    {
      "affiliations": [
        "Zuyderland Medical Center, Heerlen-Sittard, The Netherlands"
      ],
      "name": "Sofia Ramiro"
    },
    {
      "affiliations": [
        "Galicia Sur Health Research Institute (IISGS), IRIDIS (Investigation in Rheumatology and Immune-Mediated Diseases) Group, Vigo, Spain"
      ],
      "name": "José María Pego-Reigosa"
    },
    {
      "affiliations": [
        "Research Unit of Spanish Society of Rheumatology, Madrid, Spain"
      ],
      "name": "Zulema Plaza"
    },
    {
      "affiliations": [
        "Zuyderland Medical Center, Heerlen-Sittard, The Netherlands"
      ],
      "name": "Hanna Kenjic"
    },
    {
      "affiliations": [
        "Hospital General Universitario Gregorio Marañón, Madrid, Spain"
      ],
      "name": "Julia Martínez-Barrio"
    },
    {
      "affiliations": [
        "Hospital Universitario 12 de Octubre and Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain"
      ],
      "name": "María Galindo-Izquierdo"
    },
    {
      "affiliations": [
        "Hospital Universitario Araba, Vitoria-Gasteiz, Madrid, Spain"
      ],
      "name": "Jaime Calvo-Alen"
    },
    {
      "affiliations": [
        "Hospital Universitario Carlos Haya,, Malaga, Spain"
      ],
      "name": "Natalia Mena-Vazquez"
    },
    {
      "affiliations": [
        "Hospital Marina Baixa, Villajoyosa, Spain"
      ],
      "name": "José Rosas"
    },
    {
      "affiliations": [
        "IDIBELL Hospital Universitario de Bellvitge, Barcelona, Spain"
      ],
      "name": "Javier Narváez"
    },
    {
      "affiliations": [
        "Hospital General Universitario de Alicante, Alicante, Spain"
      ],
      "name": "Silvia Gómez-Sabater"
    },
    {
      "affiliations": [
        "A Coruña University Hospital, A Coruña, Spain"
      ],
      "name": "Mercedes Freire"
    },
    {
      "affiliations": [
        "Hospital Universitario de la Princesa, Madrid, Spain"
      ],
      "name": "Eva Tomero"
    },
    {
      "affiliations": [
        "University Hospital Germans Trias i Pujol, Barcelona, Spain"
      ],
      "name": "Clara Sanguesa"
    },
    {
      "affiliations": [
        "Hospital Universitari Son Llàtzer, Palma de Mallorca, Spain"
      ],
      "name": "Inmaculada Ros-Villamajó"
    },
    {
      "affiliations": [
        "Consorci Corporació Sanitària Parc Taulí, Barcelona, Spain"
      ],
      "name": "Marta Marta Arévalo-Salaet"
    },
    {
      "affiliations": [
        "University Hospital Lucus Augusti, Lugo, Spain"
      ],
      "name": "Carlota Iñiguez"
    },
    {
      "affiliations": [
        "Ramón y Cajal University Hospital, Madrid, Spain"
      ],
      "name": "Sandra Garrote"
    },
    {
      "affiliations": [
        "Hospital Universitario de Basurto, Bilbao, Spain"
      ],
      "name": "María Esther Ruiz-Lucea"
    },
    {
      "affiliations": [
        "Jerez de la Frontera General Hospital, Jerez de la Frontera, Spain"
      ],
      "name": "Raúl Menor"
    },
    {
      "affiliations": [
        "Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain"
      ],
      "name": "Iñigo Rua-Figueroa"
    }
  ],
  "title": "PT7:06 Bridging physician-defined targets and patient-perceived health: associations with PASS in the large multicenter systemic lupus erythematosus cohort RELESSER",
  "uid": "4de05987-1728-58b5-a2e2-850a673968f9"
}