Cultural and quality-of-life considerations when administering corticosteroids as a therapeutic strategy for African American women living with systemic lupus erythematosus

Figures & data

Table 1 Characteristics of participants (N = 284)

Characteristics	SLE cases (n = 224)	Related controls (n = 60)
Mean age (years) SD	39 ± 14	42 ± 15.4
Race/ethnicity
Non-Gullah African American n (%)	84 (38%)	2 (3%)
Gullah African American n (%)	87 (39%)	54 (90%)
Caucasian American n (%)	53 (24%)	4 (7%)
Education
Less than high school n (%)	2 (0.81%)	2 (3.33%)
High school n (%)	76 (31%)	16 (26.67%)
Some college n (%)	27 (11%)	18 (30%)
College n (%)	28 (11%)	9 (15%)
Technical college or trade n (%)	37 (15%)	8 (13.33%)
Postgraduate n (%)	17 (7%)	4 (6.67%)
Employment status
Working n (%)	82 (36%)	39 (65%)
Retired n (%)	15 (7%)	5 (8%)
Homemaker n (%)	9 (4%)	2 (3%)
Disabled n (%)	62 (28%)	1 (2%)
Unemployed n (%)	30 (13%)	9 (15%)
Other n (%)	18 (8%)	5 (8%)
Corticosteroid use
Mean duration years ± SD	5.57 ± 4.83	–
SLICC Disease Damage Index
Mean ± SD	2.41 ± 1.7	–

Abbreviations: SLICC, Systemic Lupus International Collaborating Clinics; SLE, Systemic lupus erythematosus.

Table 2 Differences in HRQoL scores between women with SLE and controls

Characteristics	SLE cases (n = 244)	Controls (n = 60)	p-value
	Mean ± SD	Mean ± SD
Emotional health	18.16 ± 4.80	11.80 ± 7.32	<0.01*
Physical health	22.20 ± 5.89	26.50 ± 5.53	<0.01#
Work/regular activities of daily living
Role physical	13.40 ± 4.94	16.91 ± 4.52	<0.01#
Role emotional	11.58 ± 3.67	12.62 ± 3.60	0.02#

Notes:

* Significant difference based on a Student’s t-test.

# Significant difference based on Wilcoxon rank sum test.

Abbreviation: SLE, Systemic lupus erythematosus.

Table 3 Linear regression models for the association between emotional health, physical health, and work/regular activities of daily living before and after adjusting for corticosteroid use

Model	Variables	Work/regular activities of daily living (role emotional)		Work/regular activities of daily living (role physical)
		β	p-value	β	p-value
1	Physical health	0.36	<0.01*	–	–
2	Emotional health	–	–	0.04	0.43
3	Emotional health	–	–	0.38	<0.01*
	Corticosteroids			−1.80	0.51

Notes: Models 1 and 2: unadjusted; Model 3: adjusted.

* Significant difference detected.

Table 4 Ethnic differences in HRQoL scores among women with SLE

Characteristics	Non-Gullah African Americans (n = 79)	Gullah African Americans (n = 83)	Caucasian Americans (n = 50)	p-value
	Mean ± SD	Mean ± SD	Mean ± SD
Emotional health	17.46 ± 4.70	17.70 ± 5.18	20.10 ± 3.80	0.004*
Work/regular activities of daily living
Role physical	12.74 ± 5.03	13.52 ± 4.65	14.94 ± 4.84	0.04*

Notes:

* Significant differences were observed for non-Gullah African Americans and Caucasian American women and Gullah African Americans and Caucasian American women with SLE (post hoc p < 0.05).

Abbreviation: SLE, Systemic lupus erythematosus.

Table 5 Linear regression models for the association between emotional health, physical health, and work/regular activities of daily living before and after adjusting for corticosteroid use

Models	Work/regular activities of daily living
	Role physical
	Variables	β	p-value
1	Emotional health	0.40	<0.01*
2	Emotional health	0.40	<0.01*
	Caucasian American	1.46	0.09
	Gullah African American	1.13	0.12
3	Emotional health	0.37	<0.01*
	Caucasian American	1.24	0.19
	Gullah African American	1.39	0.12
	Corticosteroid use	0.07	0.38
4	Emotional health	0.23	<0.01*
	Caucasian American	0.13	0.26
	Gullah African American	1.66	0.03*
	Education	0.72	0.29
	Age	−0.04	0.05*
	Disability status	−3.21	<0.01*
	Stroke	−0.60	0.43
	Dialysis	1.33	−0.26
	Depression	−1.77	0.02*

Notes: Model 1: unadjusted; Models 2–4: adjusted.

* Significant difference was observed.