H Babaoglu1,2, J Li1, D Goldman1, L S Magder3, M Petri1. 1. Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 2. Division of Rheumatology, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey. 3. Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland, USA.
Abstract
AIM: The Lupus Low Disease Activity State (LLDAS) is a potential treat to target goal in systemic lupus erythematosus (SLE). SLE patients in LLDAS for more than half of the observation time have about a 50% lower risk of new organ damage and have reduced mortality. We identified predictors of being in LLDAS ≥50% of the observation time. METHODS: A total of 2228 SLE patients who had at least three clinical visits were included. Percentage of time in LLDAS was calculated based on the proportion of days under observation. LLDAS-50 was defined as being in LLDAS for ≥50% of the observation time. We used the stepwise selection procedure in logistic regression to identify predictors of LLDAS-50. RESULTS: A total of 1169 (52.5%) SLE patients, but only 37.6% of African Americans, achieved LLDAS-50. In the multivariable model, African American ethnicity, hypocomplementemia, serositis, renal activity, arthritis, anti-RNP, anti-dsDNA, vasculitis, malar rash, discoid rash, thrombocytopenia, and immunosuppressive use were negative predictors of LLDAS-50. Older age at diagnosis, longer disease duration, higher education level, and greater percentage of time taking hydroxychloroquine remained positive predictors of LLDAS-50. CONCLUSION: In this large cohort, only 52.5% achieved LLDAS-50. This proportion was even less in African Americans. A higher percentage of time taking hydroxychloroquine was a modifiable positive predictor of LLDAS-50. Anti-RNP, anti-dsDNA, and low complement were negatively associated with LLDAS-50. Our findings further emphasize the importance of inclusion of African Americans in clinical trials and hydroxychloroquine adherence in both clinical practice and clinical trials.
AIM: The Lupus Low Disease Activity State (LLDAS) is a potential treat to target goal in systemic lupus erythematosus (SLE). SLEpatients in LLDAS for more than half of the observation time have about a 50% lower risk of new organ damage and have reduced mortality. We identified predictors of being in LLDAS ≥50% of the observation time. METHODS: A total of 2228 SLEpatients who had at least three clinical visits were included. Percentage of time in LLDAS was calculated based on the proportion of days under observation. LLDAS-50 was defined as being in LLDAS for ≥50% of the observation time. We used the stepwise selection procedure in logistic regression to identify predictors of LLDAS-50. RESULTS: A total of 1169 (52.5%) SLEpatients, but only 37.6% of African Americans, achieved LLDAS-50. In the multivariable model, African American ethnicity, hypocomplementemia, serositis, renal activity, arthritis, anti-RNP, anti-dsDNA, vasculitis, malar rash, discoid rash, thrombocytopenia, and immunosuppressive use were negative predictors of LLDAS-50. Older age at diagnosis, longer disease duration, higher education level, and greater percentage of time taking hydroxychloroquine remained positive predictors of LLDAS-50. CONCLUSION: In this large cohort, only 52.5% achieved LLDAS-50. This proportion was even less in African Americans. A higher percentage of time taking hydroxychloroquine was a modifiable positive predictor of LLDAS-50. Anti-RNP, anti-dsDNA, and low complement were negatively associated with LLDAS-50. Our findings further emphasize the importance of inclusion of African Americans in clinical trials and hydroxychloroquine adherence in both clinical practice and clinical trials.
Authors: Shereen Oon; Molla Huq; Vera Golder; Pei Xuan Ong; Eric F Morand; Mandana Nikpour Journal: Ann Rheum Dis Date: 2019-01-24 Impact factor: 19.103
Authors: Candace H Feldman; Linda T Hiraki; Jun Liu; Michael A Fischer; Daniel H Solomon; Graciela S Alarcón; Wolfgang C Winkelmayer; Karen H Costenbader Journal: Arthritis Rheum Date: 2013-03
Authors: Kimberly DeQuattro; Laura Trupin; Louise B Murphy; Stephanie Rush; Lindsey A Criswell; Cristina M Lanata; Maria Dall'Era; Patricia Katz; Jinoos Yazdany Journal: Arthritis Care Res (Hoboken) Date: 2022-04-20 Impact factor: 5.178
Authors: Ashley White; Trevor D Faith; Aissatou Ba; Aundrea Loftley; Viswanathan Ramakrishnan; Hetlena Johnson; Jillian Rose; Clara L Dismuke-Greer; Jim C Oates; Leonard E Egede; Edith M Williams Journal: Front Psychol Date: 2021-10-05
Authors: Moon Young Kim; Deepali Sen; Ronald R Drummond; Matthew C Brandenburg; Kathryn Lp Biesanz; Alfred Hj Kim; Seth A Eisen; Carolyn M Baum; Erin R Foster Journal: Lupus Date: 2021-04-01 Impact factor: 2.911