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 language | English |
|---|---|
| Article number | 260 |
| Pages (from-to) | 1-9 |
| Number of pages | 9 |
| Journal | Arthritis Research and Therapy |
| Volume | 18 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 9 Nov 2016 |
Keywords
- Disease activity
- Low disease activity
- Systemic lupus erythematosus
- Treatment target
Cite this
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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 journal › Article › Research › peer-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
UR - http://www.scopus.com/inward/record.url?scp=84994899442&partnerID=8YFLogxK
U2 - 10.1186/s13075-016-1163-2
DO - 10.1186/s13075-016-1163-2
M3 - Article
VL - 18
SP - 1
EP - 9
JO - Arthritis Research and Therapy
JF - Arthritis Research and Therapy
SN - 1478-6354
IS - 1
M1 - 260
ER -