G S Alarcón1,2, M F Ugarte-Gil3,4, G Pons-Estel5,6, L M Vilá7, J D Reveille8, G McGwin1. 1. 1 The University of Alabama at Birmingham, Birmingham, USA. 2. 2 Universidad Peruana Cayetano Heredia, Lima, Perú. 3. 3 Hospital Guillermo Almenara, EsSalud, Lima, Perú. 4. 4 Universidad Científica del Sur, Lima, Perú. 5. 5 Hospital Provincial de Rosario, Rosario, Argentina. 6. 6 Grupo Oroño-Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Sanatorio Parque Rosario, Santa Fe, Argentina. 7. 7 University of Puerto Rico Medical Sciences Campus, San Juan, USA. 8. 8 The University of Texas Health McGovern Medical School, Houston, USA.
Abstract
OBJECTIVE: The objective of this report is to determine the impact of remission and low disease activity state (LDAS) on damage accrual and mortality in systemic lupus erythematosus (SLE) patients. PATIENTS AND METHODS: Visits from the Lupus in Minority populations: Nature vs. Nurture (LUMINA) cohort were categorized into remission (Systemic Lupus Activity Measure (SLAM) score = 0 and prednisone ≤ 5 mg/day and no immunosuppressants), LDAS ((not on remission), SLAM score ≤ 3, prednisone ≤ 7.5 mg/day, no immunosuppressants), or neither: active. Remission and LDAS visits were combined because of the relatively small number of remission visits. Their impact on damage accrual and mortality were examined by Poisson and logistic multivariable regressions adjusting for variables known to affect these outcomes. RESULTS: A total of 3879 visits for 558 patients (28% Caucasian, 37% African descent, 35% Hispanic) were studied. These visits corresponded to 71 in remission, 585 in LDAS, and 3223 active. The longer the percentage of time the patients were in remission/LDAS, the less damage accrual observed (rate ratio 0.1773 (95% confidence interval (CI) 0.1216 to 0.2584) p < 0.0001). A trend was observed in terms of mortality although statistical significance was not reached (odds ratio 0.303 (95% CI 0.063 to 1.456), p = 0.1360). CONCLUSIONS: The longer the patient's state on Remission/LDAS, the less damage accrual that occurs. The protective effect on mortality was not statistically significant.
OBJECTIVE: The objective of this report is to determine the impact of remission and low disease activity state (LDAS) on damage accrual and mortality in systemic lupus erythematosus (SLE) patients. PATIENTS AND METHODS: Visits from the Lupus in Minority populations: Nature vs. Nurture (LUMINA) cohort were categorized into remission (Systemic Lupus Activity Measure (SLAM) score = 0 and prednisone ≤ 5 mg/day and no immunosuppressants), LDAS ((not on remission), SLAM score ≤ 3, prednisone ≤ 7.5 mg/day, no immunosuppressants), or neither: active. Remission and LDAS visits were combined because of the relatively small number of remission visits. Their impact on damage accrual and mortality were examined by Poisson and logistic multivariable regressions adjusting for variables known to affect these outcomes. RESULTS: A total of 3879 visits for 558 patients (28% Caucasian, 37% African descent, 35% Hispanic) were studied. These visits corresponded to 71 in remission, 585 in LDAS, and 3223 active. The longer the percentage of time the patients were in remission/LDAS, the less damage accrual observed (rate ratio 0.1773 (95% confidence interval (CI) 0.1216 to 0.2584) p < 0.0001). A trend was observed in terms of mortality although statistical significance was not reached (odds ratio 0.303 (95% CI 0.063 to 1.456), p = 0.1360). CONCLUSIONS: The longer the patient's state on Remission/LDAS, the less damage accrual that occurs. The protective effect on mortality was not statistically significant.
Authors: Ronald F van Vollenhoven; George Bertsias; Andrea Doria; David Isenberg; Eric Morand; Michelle A Petri; Bernardo A Pons-Estel; Anisur Rahman; Manuel Francisco Ugarte-Gil; Alexandre Voskuyl; Laurent Arnaud; Ian N Bruce; Ricard Cervera; Nathalie Costedoat-Chalumeau; Caroline Gordon; Frédéric A Houssiau; Marta Mosca; Matthias Schneider; Michael M Ward; Graciela Alarcon; Martin Aringer; Anka Askenase; Sang-Cheol Bae; Hendrika Bootsma; Dimitrios T Boumpas; Hermine Brunner; Ann Elaine Clarke; Cindy Coney; László Czirják; Thomas Dörner; Raquel Faria; Rebecca Fischer; Ruth Fritsch-Stork; Murat Inanc; Søren Jacobsen; David Jayne; Annegret Kuhn; Bernadette van Leeuw; Maarten Limper; Xavier Mariette; Sandra Navarra; Mandana Nikpour; Marzena Helena Olesinska; Guillermo Pons-Estel; Juanita Romero-Diaz; Blanca Rubio; Yehuda Schoenfeld; Eloisa Bonfá; Josef Smolen; Y K Onno Teng; Angela Tincani; Michel Tsang-A-Sjoe; Carlos Vasconcelos; Anne Voss; Victoria P Werth; Elena Zakharhova; Cynthia Aranow Journal: Lupus Sci Med Date: 2021-11
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