Contribution of abnormal BMI to adverse health-related quality of life outcomes after a 52-week therapy in patients with SLE

Objectives To investigate whether abnormal BMI is associated with adverse health-related quality of life (HRQoL) outcome, including severe fatigue, after 52weeks of standard therapy plus belimumab or placebo in patients with SLE. Methods We analysed data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials (n=1684). Adverse HRQoL was defined as SF-36 scores <= the fifth percentile in age- and sex-matched US population-based subjects, and FACIT-F scores <30. We compared BMI groups using the Pearson's (2) test, and assessed independence with multivariable logistic regression analysis. Results Overweight (BMI >= 25kg/m(2)) and obese (BMI >= 30kg/m(2)) patients showed increased likelihood to exhibit adverse SF-36 physical component summary (OR: 1.8; 95% CI: 1.4, 2.3; P <0.001 and OR: 2.4; 95% CI: 1.8, 3.2; P <0.001, respectively) and FACIT-F (OR: 1.3; 95% CI: 1.1, 1.6; P = 0.010 and OR: 1.5; 95% CI: 1.2, 2.0; P = 0.002, respectively) scores at week 52. Underweight was associated with adverse SF-36 mental component summary scores, also after adjustment for sex, ancestry, age, disease duration, disease activity, organ damage and prednisone dose during the study period (OR: 2.1; 95% CI: 1.2, 3.6; P = 0.007). Addition of belimumab to standard therapy independently protected against adverse SF-36 general health (OR: 0.8; 95% CI: 0.6, 1.0; P = 0.025) and FACIT-F<30 (OR: 0.8; 95% CI: 0.6, 1.0; P = 0.018). Conclusion Overweight and obesity contributed to adverse physical and mental HRQoL outcomes after therapeutic intervention in SLE patients, and underweight contributed to adverse mental HRQoL outcome. A protective effect of belimumab against adverse general health and severe fatigue was implicated.

Automated summary

Overweight and obesity were associated with adverse physical and mental HRQoL outcomes in SLE patients after therapeutic intervention, while underweight was linked to adverse mental HRQoL outcome. Addition of belimumab to standard therapy had a protective effect against adverse general health and severe fatigue.