Patients achieving low lupus disease activity state, systemic lupus erythematosus disease control or remission showed lower rates of organ damage during longitudinal follow-up: analysis of the Hopkins Lupus Cohort.
| Autor: | Hunnicutt J; Epidemiology, GSK, Collegeville, Pennsylvania, USA., Georgiou ME; Value Evidence and Outcomes, GSK, Brentford, UK mary.e.jones@gsk.com., Richards A; Value Evidence and Outcomes, GSK, Brentford, UK., Quasny H; Clinical Sciences, GSK, Durham, North Carolina, USA., Magder L; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA., Goldman D; Division of Rheumatology, John Hopkins University School of Medicine, Baltimore, Maryland, USA., Petri MA; Division of Rheumatology, John Hopkins University School of Medicine, Baltimore, Maryland, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Lupus science & medicine [Lupus Sci Med] 2024 Dec 11; Vol. 11 (2). Date of Electronic Publication: 2024 Dec 11. |
| DOI: | 10.1136/lupus-2024-001206 |
| Abstrakt: | Objective: One key target of treating patients with systemic lupus erythematosus (SLE) is to prevent organ damage. This analysis quantified the association between time spent in four specific SLE low disease activity (LDA) states and organ damage rate. Methods: This retrospective real-world data analysis (GSK Study 207168), undertaken to help contextualise the BLISS-BELIEVE clinical trial, included adults with SLE enrolled for≥1 year in the Hopkins Lupus Cohort and treated with standard therapy in a specialist care centre between 1987 and 2019. LDA states (Lupus Low Disease Activity State (LLDAS), disease control, clinical and complete remissions) were defined using SLE Disease Activity Index (SLEDAI)/Physician Global Assessment scores, prednisone-equivalent dose and medication use criteria combinations. Time spent in each LDA state was expressed as a percentage of total follow-up (0%; >0-<25%; 25-49%; 50-74%; ≥75%). Pooled logistic models were used to estimate adjusted rate ratios (aRR) between time spent in LDA states and organ damage rate (assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)). Results: Overall, 1632 patients experienced 1246 organ damage events. Follow-up time (calculated from days of follow-up) totalled 9841.1 person-years. At baseline, the mean (SD) SLEDAI score was 2.8 (3.3) and the mean (SD) SDI score was 1.7 (1.9). Organ damage rates were lower in patients who achieved an LDA state versus those who did not. Rates decreased with increasing time spent in each LDA state. Even a small percentage of time (>0-<25% vs 0%) spent in an LDA state was associated with reduced damage (aRR (95% CI): LLDAS, 0.75 (0.61, 0.91); disease control, 0.80 (0.68, 0.93); clinical remission, 0.73 (0.60, 0.88); complete remission, 0.80 (0.68, 0.93)). Conclusions: Regardless of definition, achieving and maintaining a low disease activity state was associated with reduced organ damage in patients with SLE. Competing Interests: Competing interests: MEG and AR are employees of GSK and hold financial equities in GSK. JH and HQ were employees of GSK and held financial equities at the time of the study. MAP has received grant/research support from AstraZeneca, Aurinia, Eli Lilly, Exagen, GSK, Janssen, and Thermo Fisher. MAP has also received consulting fees from the BPR Scientific Advisory Committee, Alexion, Amgen, AnaptysBio, Argenx, AstraZeneca, Aurinia, AXDEV, Biogen, Boston Pharmaceuticals, Caribou Biosciences, CVS Health, Eli Lilly, Gilead Biosciences, GSK, Idorsia Pharmaceuticals, Janssen, Kezar Life Sciences, Kira Pharmaceuticals, Momenta Pharmaceuticals, Nimbus Lakshmi, Proviant, Sanofi, SinoMab and UCB. MAP has done unbranded lectures for Aurinia, MedShr and Arthros-FocusMedEd, and has received consulting fees for participation in a data safety monitoring board or advisory board for EMD Serono, Emergent BioSolutions, IQVIA and PPD Development. LM and DG have no conflicts of interest to declare. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.) |
| Databáze: | MEDLINE |
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