SLICC-FI Predicts Longitudinal Quality of Life Outcomes in Latin American SLE Cohort

A longitudinal study in a Latin American Mestizo cohort has found that higher frailty scores, as measured by the Systemic Lupus International Collaborating Clinics Frailty Index (SLICC-FI), are predictive of worse health-related quality of life (QoL) in patients with systemic lupus erythematosus (SLE) as published in Arthritis Care & Research. The findings reinforce the clinical utility of the SLICC-FI as a prognostic marker for long-term outcomes in this population.

The study followed 428 patients from a single-center SLE cohort over an average of 4.7 years, capturing 2,645 visits. Health-related QoL was evaluated using the LupusQoL tool, and frailty was assessed with the SLICC-FI. Disease activity and damage were controlled for using the SLE Disease Activity Index 2000 and the SLICC/ACR Damage Index (SDI), respectively. The mean baseline SLICC-FI score was 0.17 ± 0.05, and the mean disease duration was 7.2 ± 6.6 years.

Multivariable models adjusted for clinical and demographic confounders revealed a significant association between higher SLICC-FI scores and worse future QoL in multiple domains. “Higher SLICC-FI scores predicted a higher LupusQoL score in the domains of pain, planning, emotional health, and fatigue,” the authors reported, indicating a worsening in patient-reported outcomes.

When the SLICC-FI was analyzed categorically, similar patterns were observed. Patients classified as frail or least fit experienced worse fatigue scores in subsequent visits. Importantly, patients categorized as frail (SLICC-FI >0.21) also reported significantly worse body image compared to those in the least fit group (SLICC-FI 0.03–0.10). The authors concluded, “Frailty predicted worse body image compared with least fit,” highlighting the impact of systemic frailty on self-perception in SLE.

This study offers compelling evidence for the integration of frailty assessment into routine clinical care for SLE. While disease activity remains a cornerstone of monitoring, SLICC-FI adds predictive value by capturing cumulative deficits that influence quality of life.

“Higher SLICC-FI scores predicted worse health-related QoL... Our findings reinforce the prognostic value of this tool in patients with SLE,” the investigators stated. For rheumatologists, routine SLICC-FI assessment may help identify at-risk patients and guide interventions targeting both physical frailty and psychosocial burden.

Reference
Singh A, Gamboa-Cárdenas RV, Pimentel-Quiroz V, et al. Systemic lupus international collaborating clinics frailty index predicts worsening health-related quality of life, data from the almenara lupus cohort. Arthritis Care Res (Hoboken). Published online April 4, 2025. doi:10.1002/acr.25544