Cross Cultural Validation of Work Productivity and Activity Impairment Questionnaire in Lupus Patients From Latin America.
Romina E Nieto, Lucia Hernández, Rosana Quintana, Diana Fernández-Ávila, Erika Palacios Santillan, Gisela Subils, Cintia Otaduy, Verónica Saurit, Valeria Arturi, María E Sattler, Luciana González Lucero, Wilfredo Patiño Grageda, Nicolás Pérez, Micaela Cosatti, María E Crespo Espindola, Joaquín Martínez Serventi, Ana Carolina de Oliveira E Silva Montandon, Andrese Aline Gasparin, Angela Duarte, Laissa Alvino, Eduardo F Borba, Luciana Parente, Edgard Torres Dos Reis Neto, Iris Guerra Herrera, Loreto Massardo, Gustavo Aroca Martínez, Hellen Medina, Carlos A Cañas Davila, Gerardo Quintana-Lopez, Carlos E Toro-Gutiérrez, José Martínez, Reyna E Sánchez Briones, Mario Pérez Cristóbal, Eduardo Martin-Nares, Yaneli Juárez-Vicuña, Ignacio García De La Torre, Carlos Abud Mendoza, Jorge A Esquivel-Valerio, Patricia Langjahr, Marcos A Vazquez, Jorge N Cieza Calderón, Manuel F Ugarte-Gil, Armando Calvo Quiroz, Rodamin Álvarez, Carina Pizzarossa, Álvaro Danza, José A Gómez-Puerta, Bernardo A Pons-Estel, Guillermo J Pons Estel, Ingris Peláez-Ballestas
Journal: International journal of rheumatic diseases
2026;29(4):e70641
PMID: 41974622
Abstract
OBJECTIVE
The objective of this study is to perform a cross-cultural validation of the Work Productivity and Activity Impairment (WPAI-Lupus v2.0) questionnaire in Latin American individuals with systemic lupus erythematosus (SLE), using data from the GLADEL cohort.
METHODS
GLADEL 2.0 is an observational cohort of SLE patients ≥ 18 years old. Clinical data, disease activity (SLEDAI-2 K), damage index (SDI), physician's global assessment (PGA) and patient-reported outcomes (WPAI-Lupus v2.0, LupusQoL), were assessed at baseline and during follow-up. Construct validity was evaluated through Spearman correlations with SLEDAI-2 K, SDI and LupusQoL. Internal consistency was assessed using Cronbach's alpha and responsiveness over 12 months was analyzed using the Wilcoxon signed-rank test. Appropriate statistical tests (p < 0.05) were performed using R software, version 4.4.0.
RESULTS
Among 1083 patients, 684 were evaluated at baseline and at 12 months. Cronbach's alpha values were: absenteeism 0.54; presenteeism 0.64; overall work impairment 0.62; activity impairment 0.62. WPAI-Lupus v2.0 scores correlated with SLEDAI-2 K (p < 0.001) and negatively with LupusQoL domains. Moderate correlations were observed between activity impairment and physical health, pain and planning (r ≈ -0.52 to -0.58). Presenteeism and overall work impairment also showed moderate correlations with physical health and pain domains (r ≈ -0.49 to -0.53). WPAI-Lupus v2.0 was sensitive to change over 12 months (p = 0.001) for all domains except intimate relationship.
CONCLUSIONS
WPAI-Lupus v2.0 demonstrated good validity, internal consistency, and responsiveness. It correlated with disease activity and quality of life, supporting the WPAI-Lupus v2.0 as a valid tool to assess work and activity impairment in Latin American patients with SLE.
© 2026 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.
Address:
Centro Regional de Enfermedades Autoinmunes y Reumáticas. GO-CREAR, Rosario, Argentina.; GLADEL External Consultant, Rosario, Argentina.; Instituto Enfermedades Inflamatorias e Inmunomediadas, Hospital Universitario Mayor - Méderi, Bogotá, Colombia.; Seccion Reumatologia, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.; Hospital Italiano de Córdoba, Córdoba, Argentina.; Hospital Córdoba. Sanatorio Allende. Facultad de Ciencias Médicas. Universidad Nacional de Córdoba, Córdoba, Argentina.; Hospital Privado. Centro Médico de Córdoba, Córdoba, Argentina.; Hospital San Martin de La Plata, La Plata, Argentina.; Sanatorio Británico, Rosario, Argentina.; Hospital Padilla, Tucumán, Argentina.; Hospital J.M Ramos Mejía, Buenos Aires, Argentina.; Instituto de Investigaciones Médicas Alfredo Lanari. Universidad de Buenos Aires, Buenos Aires, Argentina.; Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno" (CEMIC), Buenos Aires, Argentina.; Hospital Señor del Milagro Salta, Servicio de Reumatología, Salta, Argentina.; Hospital General de Agudos Dr. Juan A. Fernández, Buenos Aires, Argentina.; Rheumatology Unit- Hospital das Clinicas da Universidade Federal de Goias, Goias, Brazil.; Division of Rheumatology, Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Universidad Federal de Pernambuco, Recife, Brazil.; Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.; Division of Rheumatology, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/Unifesp), São Paulo, Brazil.; Hospital del Salvador, Santiago de Chile, Chile.; Facultad de Medicina. Universidad San Sebastián., Santiago de Chile, Hospital Dr. Franco Ravera Zunino, Rancagua, Chile.; Clínica de la Costa, Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla, Colombia.; Fundación Valle del Lili, Universidad Icesi, Cali, Colombia.; Facultad de Medicina, Universidad Nacional de Colombia; Hospital Universitario Fundación Santa Fe; Hospital Universitario Nacional de Colombia, Bogotá, Colombia.; Centro de Referencia en Osteoporosis & Reumatología, Pontificia Universidad Javeriana de Cali, Cali, Colombi; Division of Rheumatology, McMaster University, Canada. St. Joseph's Healthcare Hamilton, Canada.; Servicio de Reumatología, Instituto de Reumatología, Hematología y Dermatología (IRHED), Guayaquil, Ecuador.; División de Investigación en Salud, Hospital de Especialidades Dr. Antonio Fraga Mouret; Instituto Mexicano del Seguro Social, Mexico City, Mexico.; Hospital de Especialidades del Centro Médico Nacional SXXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, México.; Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.; Instituto Nacional de Cardiología Ignacio Chávez Departamento de Inmunología, Mexico City, Mexico.; Centro de Estudios de Investigación Básica y Clínica, S.C, Guadalajara, Mexico.; Facultad de Medicina de la Universidad Autónoma de San Luis Potosí y Hospital Central "Dr. Ignacio Morones Prieto", San Luis Potosí, Mexico.; Internal Medicine Department and Rheumatology Service, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico.; Facultad de Ciencias Medicas, Universidad Nacional de Asunción, Asunción, Paraguay.; Hospital Nacional Edgardo Rebagliati Martins-EsSalud, Lima, Peru.; Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémicas. Universidad Científica del Sur; Servicio de Reumatología. Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Peru.; Servicio de Inmunología y Reumatología, Hospital Nacional Cayetano Heredia. Universidad Peruana Cayetano Heredia, Lima, Peru.; Hospital Docente Padre Billini, Santo Domingo, Dominican Republic.; Unidad de Enfermedades Autoinmunes Sistémicas, Hospital de Clínicas, Facultad de Medicina, UDELAR, Montevideo, Uruguay.; Médica Uruguaya. Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.; Rheumatology Department, Hospital Clinic, Barcelona, Spain.; Rheumatology Unit. Hospital General de México "Dr.Eduardo Liceaga", Mexico City, Mexico.
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MeSH Terms:
Humans,
Lupus Erythematosus, Systemic,
Female,
Male,
Adult,
Latin America,
Reproducibility of Results,
Absenteeism,
Middle Aged,
Presenteeism,
Efficiency,
Quality of Life,
Predictive Value of Tests,
Severity of Illness Index,
Surveys and Questionnaires,
Time Factors,
Cultural Characteristics,
Work Capacity Evaluation,
Disability Evaluation,
Cross-Cultural Comparison,
Patient Reported Outcome Measures,
Young Adult,
Cost of Illness
