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Remission and low d...
Remission and low disease activity (LDA) prevent damage accrual in patients with systemic lupus erythematosus : Results from the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort
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- Ugarte-Gil, Manuel Francisco (author)
- Scientific University of the South, Lima,Hospital Nacional Guillermo Almenara Irigoyen, EsSalud
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- Hanly, John (author)
- Dalhousie University
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- Urowitz, Murray (author)
- University of Toronto
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- Gordon, Caroline (author)
- University of Birmingham
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- Bae, Sang Cheol (author)
- Hanyang University
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- Romero-Diaz, Juanita (author)
- Salvador Zubirán National Institute of Health Sciences and Nutrition
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- Sanchez-Guerrero, Jorge (author)
- Salvador Zubirán National Institute of Health Sciences and Nutrition,University of Toronto
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- Bernatsky, Sasha (author)
- McGill University
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- Clarke, Ann Elaine (author)
- Cumming School of Medicine
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- Wallace, Daniel J. (author)
- University of California, Los Angeles
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- Isenberg, David Alan (author)
- University College London
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- Rahman, Anisur (author)
- University College London
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- Merrill, Joan T. (author)
- Oklahoma Medical Research Foundation
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- Fortin, Paul R. (author)
- Laval University,Centre hospitalier universitaire de Québec
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- Gladman, Dafna D. (author)
- University of Toronto,Toronto Western Hospital
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- Bruce, Ian N. (author)
- University of Manchester
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- Petri, Michelle (author)
- Johns Hopkins University School of Medicine
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- Ginzler, Ellen M. (author)
- SUNY Downstate Health Sciences University
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- Dooley, Mary Anne (author)
- University of North Carolina
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- Ramsey-Goldman, Rosalind (author)
- Northwestern University Feinberg School of Medicine
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- Manzi, Susan (author)
- Allegheny Health Network
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- Jönsen, Andreas (author)
- Lund University,Lunds universitet,Lund SLE Research Group,Forskargrupper vid Lunds universitet,Lund University Research Groups
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- Van Vollenhoven, Ronald F. (author)
- Academic Medical Center of University of Amsterdam (AMC)
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- Aranow, Cynthia (author)
- Feinstein Institute for Medical Research
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- MacKay, Meggan (author)
- Feinstein Institute for Medical Research
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- Ruiz-Irastorza, Guillermo (author)
- University of the Basque Country
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- Lim, Sam (author)
- Emory University
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- Inanc, Murat (author)
- Istanbul University
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- Kalunian, Ken (author)
- University of California, San Diego
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- Jacobsen, Søren (author)
- University of Copenhagen
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- Peschken, Christine (author)
- University of Manitoba
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- Kamen, Diane L. (author)
- Medical University of South Carolina
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- Askanase, Anca (author)
- Columbia University
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- Pons-Estel, Bernardo A. (author)
- Grupo Oroño-Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR)
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- Alarcón, Graciela S. (author)
- University of Alabama,Cayetano Heredia University
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(creator_code:org_t)
- 2022-08-09
- 2022
- English.
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In: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967 .- 1468-2060. ; 81:11, s. 1541-1548
- Related links:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Objective: To determine the independent impact of different definitions of remission and low disease activity (LDA) on damage accrual. Methods: Patients with ≥2 annual assessments from a longitudinal multinational inception lupus cohort were studied. Five mutually exclusive disease activity states were defined: remission off-treatment: clinical Systemic Lupus Erythematosus Disease Activity Index (cSLEDAI)-2K=0, without prednisone or immunosuppressants; remission on-treatment: cSLEDAI-2K score=0, prednisone ≤5 mg/day and/or maintenance immunosuppressants; low disease activity Toronto cohort (LDA-TC): cSLEDAI-2K score of ≤2, without prednisone or immunosuppressants; modified lupus low disease activity (mLLDAS): Systemic Lupus Erythematosus Disease Activity Index-2K score of 4 with no activity in major organ/systems, no new disease activity, prednisone ≤7.5 mg/day and/or maintenance immunosuppressants; active: all remaining visits. Only the most stringent definition was used per visit. Antimalarials were allowed in all. The proportion of time that patients were in a specific state at each visit since cohort entry was determined. Damage accrual was ascertained with the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). Univariable and multivariable generalised estimated equation negative binomial regression models were used. Time-dependent covariates were determined at the same annual visit as the disease activity state but the SDI at the subsequent visit. Results: There were 1652 patients, 1464 (88.6%) female, mean age at diagnosis 34.2 (SD 13.4) years and mean follow-up time of 7.7 (SD 4.8) years. Being in remission off-treatment, remission on-treatment, LDA-TC and mLLDAS (per 25% increase) were each associated with a lower probability of damage accrual (remission off-treatment: incidence rate ratio (IRR)=0.75, 95% CI 0.70 to 0.81; remission on-treatment: IRR=0.68, 95% CI 0.62 to 0.75; LDA: IRR=0.79, 95% CI 0.68 to 0.92; and mLLDAS: IRR=0.76, 95% CI 0.65 to 0.89)). Conclusions: Remission on-treatment and off-treatment, LDA-TC and mLLDAS were associated with less damage accrual, even adjusting for possible confounders and effect modifiers.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
Keyword
- Epidemiology
- Health care
- Outcome assessment
- Systemic lupus erythematosus
Publication and Content Type
- art (subject category)
- ref (subject category)
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Ugarte-Gil, Manu ...
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Hanly, John
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Urowitz, Murray
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Gordon, Caroline
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Bae, Sang Cheol
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Romero-Diaz, Jua ...
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Sanchez-Guerrero ...
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Bernatsky, Sasha
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Clarke, Ann Elai ...
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Wallace, Daniel ...
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Isenberg, David ...
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Rahman, Anisur
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Merrill, Joan T.
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Fortin, Paul R.
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Gladman, Dafna D ...
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Bruce, Ian N.
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Petri, Michelle
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Ginzler, Ellen M ...
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Dooley, Mary Ann ...
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Ramsey-Goldman, ...
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Manzi, Susan
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Jönsen, Andreas
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Van Vollenhoven, ...
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Aranow, Cynthia
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MacKay, Meggan
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Ruiz-Irastorza, ...
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Lim, Sam
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Inanc, Murat
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Kalunian, Ken
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Jacobsen, Søren
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Peschken, Christ ...
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Kamen, Diane L.
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Askanase, Anca
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Pons-Estel, Bern ...
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Alarcón, Graciel ...
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Lund University