Association of Lupus Low Disease Activity State And Remission With Reduced Organ Damage And Flare in Systemic lupus erythematosus Patients With High Disease Activity.

Autor:	Kandane-Rathnayake R; Department of Medicine, Sub-faculty of Clinical and Molecular Medicine, Monash University, Clayton, Victoria, Australia., Golder V; Department of Medicine, Sub-faculty of Clinical and Molecular Medicine, Monash University, Clayton, Victoria, Australia., Louthrenoo W; Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Thailand., Chen YH; Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan., Cho J; Rheumatology Division, University Medical Cluster, National University Hospital, Singapore., Lateef A; Rheumatology Division, University Medical Cluster, National University Hospital, Singapore; Department of Medicine, Woodlands Health, Singapore., Hamijoyo L; Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Padjadjaran, Bandung, Indonesia., Luo SF; Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taipei, Taiwan., Wu YJ; Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taipei, Taiwan., Navarra SV; Rheumatology Center, University of Santo Tomas Hospital, Manila, Philippines., Zamora L; Rheumatology Center, University of Santo Tomas Hospital, Manila, Philippines., Li Z; Department of Rheumatology and Immunology, People's Hospital Peking University Health Sciences Centre, Beijing, China., Sockalingam S; Department of Medicine, Faculty of Medicine Building, University of Malaya Medical Centre, Kuala Lumpur, Malaysia., Katsumata Y; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan., Harigai M; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan., Hao Y; Rheumatology and Immunology department, Peking University First Hospital, Beijing, China.; Department of Rheumatology, St Vincent's Hospital, Melbourne Victoria, Australia., Zhang Z; Rheumatology and Immunology department, Peking University First Hospital, Beijing, China., Basnayake BMDB; Department of Nephrology, Teaching Hospital, Kandy, Sri Lanka., Chan M; Department of Rheumatology, Allergy & Immunology, Tan Tock Seng Hospital, Singapore., Kikuchi J; Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan., Takeuchi T; Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.; Saitama Medical University, Saitama, Japan., Bae SC; Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea.; Hanyang University Institute for Rheumatology Research and Hanyang University Institute of Bioscience and Biotechnology, Seoul, South Korea., Oon S; Department of Rheumatology, St Vincent's Hospital, Melbourne Victoria, Australia., O'Neill S; Rheumatology department, Liverpool Hospital and the University of Sydney, New South Wales, Australia., Goldblatt F; Department of Rheumatology, Flinders Medical Centre, Bedford Park, South Australia, Australia., Ng KPL; Department of Rheumatology, Health New Zealand Waitemata, Te Whatu Ora (North Shore Hospital), Auckland, New Zealand., Law A; Singapore General Hospital and Asia Arthritis and Rheumatology Centre, Singapore., Tugnet N; Health New Zealand Auckland, Te Whatu Ora (Greenlane Clinical Centre), Auckland, New Zealand., Kumar S; Health New Zealand Counties Manukau, Te Whatu Ora (Middlemore Hospital), Auckland, New Zealand., Tee C; University of the Philippines, Manila, Philippines., Tee M; University of the Philippines, Manila, Philippines., Ohkubo N; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan., Tanaka Y; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan., Lau CS; Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong., Nikpour M; Department of Rheumatology, St Vincent's Hospital, Melbourne Victoria, Australia.; The University of Sydney School of Public Health, New South Wales, Australia., Morand EF; Department of Medicine, Sub-faculty of Clinical and Molecular Medicine, Monash University, Clayton, Victoria, Australia., Hoi A; Department of Medicine, Sub-faculty of Clinical and Molecular Medicine, Monash University, Clayton, Victoria, Australia.
Jazyk:	angličtina
Zdroj:	Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2024 Dec 04. Date of Electronic Publication: 2024 Dec 04.
DOI:	10.1093/rheumatology/keae631
Abstrakt:	Objective: High disease activity status (HDAS) in patients with systemic lupus erythematosus (SLE) is associated with adverse long-term outcomes. We examined the frequency of lupus low disease activity state (LLDAS) and remission (REM) attainment in HDAS patients and whether their attainment was associated with improved patient outcomes. Methods: Demographic, clinical and outcomes data, collected prospectively from a multinational cohort between 2013 and 2020, were analysed. Disease activity was assessed using SLEDAI-2K. HDAS was defined as SLEDAI-2K ≥ 10. Patients' first visit with SLEDAI-2K ≥ 10 was assigned as baseline. Survival analyses were performed to examine the associations between cumulative and sustained LLDAS and REM attainment in HDAS patients and subsequent organ damage accrual and flare. Results: 1,029 HDAS patients with a median study duration of 2.7 years [IQR: 1.0, 4.8] were studied. LLDAS and REM were attained at least once by 71% (LLDAS-ever, n = 726) and 41% (REM-ever, n = 418) of patients. Approximately one-fifth of patients attained ≥50% cumulative time in LLDAS or REM. 37% (n = 385) of patients attained ≥3months of sustained LLDAS, with progressively lower proportions of patients attaining longer periods of sustained LLDAS. Lower proportions of patients attained sustained REM. Attainment of cumulative and sustained LLDAS or REM provided significant protection against damage accrual and flare in HDAS patients. Sustained periods of LLDAS and REM were difficult to achieve and therefore a more stringent target, but provided the most protection against damage accrual or flare. Conclusion: LLDAS and REM were achievable targets in HDAS patients, and provided significant protection against adverse outcomes. (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology.)
Databáze:	MEDLINE
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