Perceptions of SLE flare differ between patients, physicians

Patients differ from physicians regarding their views of systemic lupus erythematosus (SLE) flares, a study has found. The former see flares as days of having fatigue, pain, and skin issues, while the latter define flares as periods of elevated clinical SLE activity.

A qualitative descriptive study was carried out using in-depth interviews with a purposeful sample of SLE patients, who met the 1997 American College of Rheumatology or Systemic Lupus International Collaborating Clinics criteria, and practicing rheumatologists. The researchers used applied thematic analysis to record, transcribe, and evaluate the interviews.

Forty-two SLE patients, representing a range of SLE activity, completed the interviews. Most of them characterized flare symptoms as joint pain, skin issues, and fatigue lasting for several days. Only a few included objective signs or laboratory measures as features of SLE flare.

On the other hand, 13 rheumatologists from 10 academic and three community settings completed the interviews. Most of them described flare as increased or worsening SLE disease activity, and a little more than half of them included objective findings. Nearly half of the physicians also included fatigue, pain, and other patient-reported symptoms.

“Our findings suggest the current definition of flare may be insufficient to integrate both perceptions,” the researchers said. “Further study is needed to understand the pathophysiology of patient flares and the best way to incorporate patients’ perspectives into clinical assessments.”

SLE flares often result in “increased damage and decreased health-related quality of life,” according to the researchers.