Details

Autor(en) / Beteiligte

• Ugarte-Gil, Manuel Francisco
• Wojdyla, Daniel
• Pons-Estel, Guillermo J
• Catoggio, Luis J
• Drenkard, Cristina
• Sarano, Judith
• Berbotto, Guillermo A
• Borba, Eduardo F
• Sato, Emilia Inoue
• Tavares Brenol, João C
• Uribe, Oscar
• Ramirez Gómez, Luis A
• Guibert-Toledano, Marlene
• Massardo, Loreto
• Cardiel, Mario H
• Silveira, Luis H
• Chacón-Diaz, Rosa
• Alarcón, Graciela S
• Pons-Estel, Bernardo A

Titel

Remission and Low Disease Activity Status (LDAS) protect lupus patients from damage occurrence: data from a multiethnic, multinational Latin American Lupus Cohort (GLADEL)

Ist Teil von

• Annals of the rheumatic diseases, 2017-12, Vol.76 (12), p.2071-2074

Ort / Verlag

England

Erscheinungsjahr

2017

Quelle

MEDLINE

Beschreibungen/Notizen

• To evaluate disease activity statuses' (DAS') impact on systemic lupus erythematosus (SLE) outcomes. Four DAS were defined: remission off-therapy: SLE Disease Activity Index (SLEDAI)=0, no prednisone or immunosuppressive drugs (IS); remission on-therapy: SLEDAI=0, prednisone ≤5 mg/day and/or IS (maintenance); low (L) DAS: SLEDAI ≤4, prednisone ≤7.5 mg/day and/or IS (maintenance); non-optimally controlled: SLEDAI >4 and/or prednisone >7.5 mg/day and/or IS (induction). Antimalarials were allowed in all. Predefined outcomes were mortality, new damage (increase of at least one Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index (SDI) point) and severe new damage (increase of at least 3 SDI points). Univariable and multivariable Cox regression models were performed to define the impact of DAS, as time-dependent variable, on these outcomes. 1350 patients were included, 79 died during follow-up, 606 presented new and 177 severe new damage. In multivariable analyses, remission (on/off-therapy) was associated with a lower risk of new (HR 0.60; 95% CI 0.43 to 0.85), and of severe new damage (HR 0.32; 95% CI 0.15 to 0.68); low disease activity status (LDAS) was associated with a lower risk of new damage (HR 0.66; 95% CI 0.48 to 0.93) compared with non-optimally controlled. No significant effect on mortality was observed. Remission was associated with a lower risk of new and severe new damage; LDAS with a lower risk of new damage after adjusting for other damage confounders.