Frequency and predictors of the lupus low disease activity state in a multi-national and multi-ethnic cohort

Vera Golder, Rangi Kandane-Rathnayake, Alberta Yik-Bun Hoi, Molla Huq, Worawit Louthrenoo, Yuan An, Zhan Guo Li, Shue Fen Luo, Sargunan Sockalingam, Chak Sing Lau, Alfred Lok Lee, Mo Yin Mok, Aisha Lateef, Kate Franklyn, Susan Morton, Sandra Teresa V Navarra, Leonid Zamora, Yeong Jian Wu, Laniyati Hamijoyo, Madelynn Chan & 5 others Sean O'Neill, Fiona Goldblatt, Eric Francis Morand, Mandana Nikpour, the Asia-Pacific Lupus Collaboration

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Abstract

Background: Systemic lupus erythematosus (SLE) is a chronic heterogeneous disease with considerable burden from disease activity and damage. A novel clinical treatment target in the form of the lupus low disease activity state (LLDAS) has been recently reported, with retrospective validation showing that time spent in LLDAS translates to reduced damage accrual. The objectives of this study were to describe the frequency and identify the predictors of attaining LLDAS in a large multinational cohort of patients with SLE. Methods: Data were collected at the recruitment visit in patients with SLE enrolled in a longitudinal study in nine countries. Data were analysed cross-sectionally against the recently published definition of LLDAS, and the frequency and characteristics associated with presence of LLDAS were determined. Stepwise multivariable logistic regression was used to determine predictors of LLDAS. Results: Of the 1846 patients assessed, criteria for LLDAS were met by 44 %. Patients with shorter disease duration were less likely to be in LLDAS (OR 0.31, 95 % CI 0.19-0.49, p<0.001). Likewise, patients with a history of discoid rash (OR 0.66, 95 % CI 0.49-0.89, p=0.006), renal disease (OR 0.60, 95 % CI 0.48-0.75, p<0.001), elevated double stranded DNA (OR 0.65, 95 % CI 0.53-0.81, p<0.001) or hypocomplementaemia (OR 0.52, 95 % CI 0.40-0.67, p<0.001) were less likely to be in LLDAS. When countries were compared, higher national social wealth (OR 1.57, 95 % CI 1.25-1.98, p<0.001) as measured by the gross domestic product per capita was positively associated with LLDAS, but ethnicity was not. Conclusion: The lupus low disease activity state is observed in less than half of patients with SLE at a single point in time. Disease duration and phenotype, and national social wealth, are predictive of LLDAS.

Original languageEnglish
Article number260
Pages (from-to)1-9
Number of pages9
JournalArthritis Research and Therapy
Volume18
Issue number1
DOIs
Publication statusPublished - 9 Nov 2016

Keywords

  • Disease activity
  • Low disease activity
  • Systemic lupus erythematosus
  • Treatment target

Cite this

Golder, Vera ; Kandane-Rathnayake, Rangi ; Hoi, Alberta Yik-Bun ; Huq, Molla ; Louthrenoo, Worawit ; An, Yuan ; Li, Zhan Guo ; Luo, Shue Fen ; Sockalingam, Sargunan ; Lau, Chak Sing ; Lee, Alfred Lok ; Mok, Mo Yin ; Lateef, Aisha ; Franklyn, Kate ; Morton, Susan ; Navarra, Sandra Teresa V ; Zamora, Leonid ; Wu, Yeong Jian ; Hamijoyo, Laniyati ; Chan, Madelynn ; O'Neill, Sean ; Goldblatt, Fiona ; Morand, Eric Francis ; Nikpour, Mandana ; the Asia-Pacific Lupus Collaboration. / Frequency and predictors of the lupus low disease activity state in a multi-national and multi-ethnic cohort. In: Arthritis Research and Therapy. 2016 ; Vol. 18, No. 1. pp. 1-9.
@article{42becea442d74a72be409550fc328c65,
title = "Frequency and predictors of the lupus low disease activity state in a multi-national and multi-ethnic cohort",
abstract = "Background: Systemic lupus erythematosus (SLE) is a chronic heterogeneous disease with considerable burden from disease activity and damage. A novel clinical treatment target in the form of the lupus low disease activity state (LLDAS) has been recently reported, with retrospective validation showing that time spent in LLDAS translates to reduced damage accrual. The objectives of this study were to describe the frequency and identify the predictors of attaining LLDAS in a large multinational cohort of patients with SLE. Methods: Data were collected at the recruitment visit in patients with SLE enrolled in a longitudinal study in nine countries. Data were analysed cross-sectionally against the recently published definition of LLDAS, and the frequency and characteristics associated with presence of LLDAS were determined. Stepwise multivariable logistic regression was used to determine predictors of LLDAS. Results: Of the 1846 patients assessed, criteria for LLDAS were met by 44 {\%}. Patients with shorter disease duration were less likely to be in LLDAS (OR 0.31, 95 {\%} CI 0.19-0.49, p<0.001). Likewise, patients with a history of discoid rash (OR 0.66, 95 {\%} CI 0.49-0.89, p=0.006), renal disease (OR 0.60, 95 {\%} CI 0.48-0.75, p<0.001), elevated double stranded DNA (OR 0.65, 95 {\%} CI 0.53-0.81, p<0.001) or hypocomplementaemia (OR 0.52, 95 {\%} CI 0.40-0.67, p<0.001) were less likely to be in LLDAS. When countries were compared, higher national social wealth (OR 1.57, 95 {\%} CI 1.25-1.98, p<0.001) as measured by the gross domestic product per capita was positively associated with LLDAS, but ethnicity was not. Conclusion: The lupus low disease activity state is observed in less than half of patients with SLE at a single point in time. Disease duration and phenotype, and national social wealth, are predictive of LLDAS.",
keywords = "Disease activity, Low disease activity, Systemic lupus erythematosus, Treatment target",
author = "Vera Golder and Rangi Kandane-Rathnayake and Hoi, {Alberta Yik-Bun} and Molla Huq and Worawit Louthrenoo and Yuan An and Li, {Zhan Guo} and Luo, {Shue Fen} and Sargunan Sockalingam and Lau, {Chak Sing} and Lee, {Alfred Lok} and Mok, {Mo Yin} and Aisha Lateef and Kate Franklyn and Susan Morton and Navarra, {Sandra Teresa V} and Leonid Zamora and Wu, {Yeong Jian} and Laniyati Hamijoyo and Madelynn Chan and Sean O'Neill and Fiona Goldblatt and Morand, {Eric Francis} and Mandana Nikpour and {the Asia-Pacific Lupus Collaboration}",
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doi = "10.1186/s13075-016-1163-2",
language = "English",
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pages = "1--9",
journal = "Arthritis Research and Therapy",
issn = "1478-6354",
publisher = "Springer-Verlag London Ltd.",
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Golder, V, Kandane-Rathnayake, R, Hoi, AY-B, Huq, M, Louthrenoo, W, An, Y, Li, ZG, Luo, SF, Sockalingam, S, Lau, CS, Lee, AL, Mok, MY, Lateef, A, Franklyn, K, Morton, S, Navarra, STV, Zamora, L, Wu, YJ, Hamijoyo, L, Chan, M, O'Neill, S, Goldblatt, F, Morand, EF, Nikpour, M & the Asia-Pacific Lupus Collaboration 2016, 'Frequency and predictors of the lupus low disease activity state in a multi-national and multi-ethnic cohort', Arthritis Research and Therapy, vol. 18, no. 1, 260, pp. 1-9. https://doi.org/10.1186/s13075-016-1163-2

Frequency and predictors of the lupus low disease activity state in a multi-national and multi-ethnic cohort. / Golder, Vera; Kandane-Rathnayake, Rangi; Hoi, Alberta Yik-Bun; Huq, Molla; Louthrenoo, Worawit; An, Yuan; Li, Zhan Guo; Luo, Shue Fen; Sockalingam, Sargunan; Lau, Chak Sing; Lee, Alfred Lok; Mok, Mo Yin; Lateef, Aisha; Franklyn, Kate; Morton, Susan; Navarra, Sandra Teresa V; Zamora, Leonid; Wu, Yeong Jian; Hamijoyo, Laniyati; Chan, Madelynn; O'Neill, Sean; Goldblatt, Fiona; Morand, Eric Francis; Nikpour, Mandana; the Asia-Pacific Lupus Collaboration.

In: Arthritis Research and Therapy, Vol. 18, No. 1, 260, 09.11.2016, p. 1-9.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Frequency and predictors of the lupus low disease activity state in a multi-national and multi-ethnic cohort

AU - Golder, Vera

AU - Kandane-Rathnayake, Rangi

AU - Hoi, Alberta Yik-Bun

AU - Huq, Molla

AU - Louthrenoo, Worawit

AU - An, Yuan

AU - Li, Zhan Guo

AU - Luo, Shue Fen

AU - Sockalingam, Sargunan

AU - Lau, Chak Sing

AU - Lee, Alfred Lok

AU - Mok, Mo Yin

AU - Lateef, Aisha

AU - Franklyn, Kate

AU - Morton, Susan

AU - Navarra, Sandra Teresa V

AU - Zamora, Leonid

AU - Wu, Yeong Jian

AU - Hamijoyo, Laniyati

AU - Chan, Madelynn

AU - O'Neill, Sean

AU - Goldblatt, Fiona

AU - Morand, Eric Francis

AU - Nikpour, Mandana

AU - the Asia-Pacific Lupus Collaboration

PY - 2016/11/9

Y1 - 2016/11/9

N2 - Background: Systemic lupus erythematosus (SLE) is a chronic heterogeneous disease with considerable burden from disease activity and damage. A novel clinical treatment target in the form of the lupus low disease activity state (LLDAS) has been recently reported, with retrospective validation showing that time spent in LLDAS translates to reduced damage accrual. The objectives of this study were to describe the frequency and identify the predictors of attaining LLDAS in a large multinational cohort of patients with SLE. Methods: Data were collected at the recruitment visit in patients with SLE enrolled in a longitudinal study in nine countries. Data were analysed cross-sectionally against the recently published definition of LLDAS, and the frequency and characteristics associated with presence of LLDAS were determined. Stepwise multivariable logistic regression was used to determine predictors of LLDAS. Results: Of the 1846 patients assessed, criteria for LLDAS were met by 44 %. Patients with shorter disease duration were less likely to be in LLDAS (OR 0.31, 95 % CI 0.19-0.49, p<0.001). Likewise, patients with a history of discoid rash (OR 0.66, 95 % CI 0.49-0.89, p=0.006), renal disease (OR 0.60, 95 % CI 0.48-0.75, p<0.001), elevated double stranded DNA (OR 0.65, 95 % CI 0.53-0.81, p<0.001) or hypocomplementaemia (OR 0.52, 95 % CI 0.40-0.67, p<0.001) were less likely to be in LLDAS. When countries were compared, higher national social wealth (OR 1.57, 95 % CI 1.25-1.98, p<0.001) as measured by the gross domestic product per capita was positively associated with LLDAS, but ethnicity was not. Conclusion: The lupus low disease activity state is observed in less than half of patients with SLE at a single point in time. Disease duration and phenotype, and national social wealth, are predictive of LLDAS.

AB - Background: Systemic lupus erythematosus (SLE) is a chronic heterogeneous disease with considerable burden from disease activity and damage. A novel clinical treatment target in the form of the lupus low disease activity state (LLDAS) has been recently reported, with retrospective validation showing that time spent in LLDAS translates to reduced damage accrual. The objectives of this study were to describe the frequency and identify the predictors of attaining LLDAS in a large multinational cohort of patients with SLE. Methods: Data were collected at the recruitment visit in patients with SLE enrolled in a longitudinal study in nine countries. Data were analysed cross-sectionally against the recently published definition of LLDAS, and the frequency and characteristics associated with presence of LLDAS were determined. Stepwise multivariable logistic regression was used to determine predictors of LLDAS. Results: Of the 1846 patients assessed, criteria for LLDAS were met by 44 %. Patients with shorter disease duration were less likely to be in LLDAS (OR 0.31, 95 % CI 0.19-0.49, p<0.001). Likewise, patients with a history of discoid rash (OR 0.66, 95 % CI 0.49-0.89, p=0.006), renal disease (OR 0.60, 95 % CI 0.48-0.75, p<0.001), elevated double stranded DNA (OR 0.65, 95 % CI 0.53-0.81, p<0.001) or hypocomplementaemia (OR 0.52, 95 % CI 0.40-0.67, p<0.001) were less likely to be in LLDAS. When countries were compared, higher national social wealth (OR 1.57, 95 % CI 1.25-1.98, p<0.001) as measured by the gross domestic product per capita was positively associated with LLDAS, but ethnicity was not. Conclusion: The lupus low disease activity state is observed in less than half of patients with SLE at a single point in time. Disease duration and phenotype, and national social wealth, are predictive of LLDAS.

KW - Disease activity

KW - Low disease activity

KW - Systemic lupus erythematosus

KW - Treatment target

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DO - 10.1186/s13075-016-1163-2

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