Self-reported depression on the Lupus Impact Tracker questionnaire (LIT) is associated with glucocorticoid use and fibromyalgia in systemic lupus erythematosus, according to RELESSER-PROS registry data

Abstract

Objective lo assess the prevalence and persistence of self-reported depression and its associated factors in patients with systemic lupus erythematosus (SLE), using a patient-reported outcome measure in a large, multicentre, prospective cohort. Methods We conducted a longitudinal analysis of patients enrolled in the RELESSER-PROS registry who responded to item 7 (I was depressed) of the Lupus Impact Tracker questionnaire (LITQ7) over five annual visits. Self-reported depression was defined as any response other than none of the time. Covariates assessed at each visit included: age, disease duration, SELENA-SLEDAI (S-SLEDAI), glucocorticoid (GC) use, SLICC/ACR Damage Index (SDI), fibromyalgia, Charlson index, BMI, smoking status, menopause, sedentary lifestyle, marital and employment status. Generalized estimating equation (GEE) models were used to examine longitudinal associations. Results Of 1463 patients (mean age 55 years; 90% female), 89.9% reported depressive symptoms at least once; 26.5% reported feeling depressed most of the time at all five visits. Patients with self-reported depression in LIT accumulated significantly more damage over time (p = 0.009) In multivariable analysis, fibromyalgia (OR 2.90; 95% CI: 1.58-5.33) and GC use (OR 1.85; 95% CI: 1.17-2.93) were independently associated with self-reported depression. Conclusions Self-reported depression is highly prevalent and often persistent among patients with SLE. Its association with potentially modifiable factors such as GC use and fibromyalgia highlights the value of integrating patient-reported outcomes such as LIT into longitudinal care, potentially contributing to improve emotional well-being. Key points center dot Depression is highly prevalent and frequently persistent in patients with systemic lupus erythematosus (SLE), even when not formally diagnosed. center dot The Lupus Impact Tracker (LIT ), a validated patient-reported outcome measure, captures depressive symptoms simply and effectively through its item 7 (LITQ7). center dot Self-reported depression was strongly associated with glucocorticoid use and fibromyalgia-both potentially modifiable factors. center dot Integrating PROMs like the LIT into routine care could facilitate early detection of emotional distress and inform patient-centered management strategies in SLE.