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

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

Author Francisco Ugarte-Gil, Manuel Google Scholar
Wojdyla, Daniel Google Scholar
Pons-Estel, Guillermo J. Google Scholar
Catoggio, Luis J. Google Scholar
Drenkard, Cristina Google Scholar
Sarano, Judith Google Scholar
Berbotto, Guillermo A. Google Scholar
Borba, Eduardo F. Google Scholar
Sato, Emilia Inoue Autor UNIFESP Google Scholar
Tavares Brenol, Joao C. Google Scholar
Uribe, Oscar Google Scholar
Ramirez Gomez, Luis A. Google Scholar
Guibert-Toledano, Marlene Google Scholar
Massardo, Loreto Google Scholar
Cardiel, Mario H. Google Scholar
Silveira, Luis H. Google Scholar
Chacon-Diaz, Rosa Google Scholar
Alarcon, Graciela S. Google Scholar
Pons-Estel, Bernardo A. Google Scholar
Abstract Objective To evaluate disease activity statuses' (DAS') impact on systemic lupus erythematosus (SLE) outcomes. Materials and methods 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. Results 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. Conclusions 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.
xmlui.dri2xhtml.METS-1.0.item-coverage London
Language English
Date 2017
Published in Annals Of The Rheumatic Diseases. London, v. 76, n. 12, p. 2071-2074, 2017.
ISSN 0003-4967 (Sherpa/Romeo, impact factor)
Publisher Bmj Publishing Group
Extent 2071-2074
Origin http://dx.doi.org/10.1136/annrheumdis-2017-211814
Access rights Closed access
Type Article
Web of Science ID WOS:000417061500024
URI https://repositorio.unifesp.br/handle/11600/58101

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