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

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art_UGARTE-GIL_Remission_and_Low_Disease_Activity_Status_LDAS_protect_2017.PDF (292.72 KB)
Citações na Scopus
89
Tipo de produção
article
Data de publicação
2017
DOI
Scopus
Web of Science
PubMed
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ISSN da Revista
Título do Volume
Editora
BMJ PUBLISHING GROUP
Autores
UGARTE-GIL, Manuel Francisco
WOJDYLA, Daniel
PONS-ESTEL, Guillermo J.
CATOGGIO, Luis J.
DRENKARD, Cristina
SARANO, Judith
BERBOTTO, Guillermo A.
SATO, Emilia Inoue
BRENOL, Joao C. Tavares
Citação
ANNALS OF THE RHEUMATIC DISEASES, v.76, n.12, p.2071-2074, 2017
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Resumo
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.
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https://observatorio.fm.usp.br/handle/OPI/25479
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - LIM/17
Artigos e Materiais de Revistas Científicas - ODS/03