RT Journal Article
SR Electronic
T1 The effect of different durations of remission on damage accrual: results from a prospective monocentric cohort of Caucasian patients
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 562
OP 565
DO 10.1136/annrheumdis-2016-210154
VO 76
IS 3
A1 Zen, Margherita
A1 Iaccarino, Luca
A1 Gatto, Mariele
A1 Bettio, Silvano
A1 Saccon, Francesca
A1 Ghirardello, Anna
A1 Punzi, Leonardo
A1 Doria, Andrea
YR 2017
UL http://ard.bmj.com/content/76/3/562.abstract
AB Aim To identify the shortest duration of remission associated with improved outcomes in systemic lupus erythematosus (SLE).Methods We studied 293 Caucasian patients with SLE during 7-year follow-up. Disease activity was assessed by SLE Disease Activity Index 2000 and damage by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). We defined three remission levels: complete, clinical off-corticosteroids, clinical on-corticosteroids (prednisone 1–5 mg/day). The effect of different durations of remission (1, 2, 3, 4 and ≥5 consecutive years) on damage was evaluated by multivariate logistic regression analysis.Results Among patients achieving 1-year (27 patients), 2-year (47 patients), 3-year (45 patients), 4-year (26 patients) remission, damage was similar irrespective of the level of remission achieved, whereas, among patients achieving ≥5-year remission (113 patients), damage was higher in those in clinical remission on-corticosteroids (p<0.001).In multivariate analysis, ≥2 consecutive year remission was protective against damage (OR (95% CI)): 2 years 0.228 (0.061 to 0.850); 3 years 0.116 (0.031 to 0.436); 4 years 0.118 (0.027 to 0.519) and ≥5 years 0.044 (0.012 to 0.159). Predictors of damage were cumulative prednisone dose ≥180 mg/month (3.136 (1.276 to 7.707)), antiphospholipid antibody syndrome (5.517 (2.092 to 14.546)), vasculitis (3.107 (1.030 to 9.307)) and number of flare/year (8.769 (1.692 to 45.449)).Conclusions Two consecutive years is the shortest duration of remission associated with a decrease in damage progression in Caucasian patients with SLE.