Title
Predictors of remission and low disease activity state in systemic lupus erythematosus: Data from a multiethnic, multinational Latin American cohort
Date Issued
01 January 2019
Access level
metadata only access
Resource Type
journal article
Author(s)
Wojdyla D.
Pons-Estel G.J.
Quintana R.
Gómez-Puerta J.A.
Catoggio L.J.
Alvarellos A.
Saurit V.
Borba E.
Sato E.
Costallat L.
da Silva N.A.
Iglesias-Gamarra A.
Neira O.
Reyes-Llerena G.
Cardiel M.H.
Amigo M.C.
Esteva-Spinetti M.H.
Pons-Estel B.A.
Publisher(s)
Journal of Rheumatology
Abstract
Objective. To determine the predictors of remission and low disease activity state (LDAS) in patients with systemic lupus erythematosus (SLE). Methods. Three disease activity states were defined: Remission = SLE Disease Activity Index (SLEDAI) = 0 and prednisone ≤ 5 mg/day and/or immunosuppressants (maintenance dose); LDAS = SLEDAI ≤ 4, prednisone ≤ 7.5 mg/day and/or immunosuppressants (maintenance dose); and non-optimally controlled state = SLEDAI > 4 and/or prednisone > 7.5 mg/day and/or immunosuppressants (induction dose). Antimalarials were allowed in all groups. Patients with at least 2 SLEDAI reported and not optimally controlled at entry were included in these analyses. Outcomes were remission and LDAS. Multivariable Cox regression models (stepwise selection procedure) were performed for remission and for LDAS. Results. Of 1480 patients, 902 were non-optimally controlled at entry; among them, 196 patients achieved remission (21.7%) and 314 achieved LDAS (34.8%). Variables predictive of a higher probability of remission were the absence of mucocutaneous manifestations (HR 1.571, 95% CI 1.064–2.320), absence of renal involvement (HR 1.487, 95% CI 1.067–2.073), and absence of hematologic involvement (HR 1.354, 95% CI 1.005–1.825); the use of immunosuppressive drugs before the baseline visit (HR 1.468, 95% CI 1.025–2.105); and a lower SLEDAI score at entry (HR 1.028, 95% CI 1.006–1.051 per 1-unit decrease). These variables were predictive of LDAS: older age at entry, per 5-year increase (HR 1.050, 95% CI 1.004–1.098); absence of mucocutaneous manifestations (HR 1.401, 95% CI 1.016–1.930) and renal involvement (HR 1.344, 95% CI 1.049–1.721); and lower SLEDAI score at entry (HR 1.025, 95% CI 1.009–1.042). Conclusion. Absence of mucocutaneous, renal, and hematologic involvement, use of immunosuppressive drugs, and lower disease activity early in the course of the disease were predictive of remission in patients with SLE; older age was predictive of LDAS.
Start page
1299
End page
1308
Volume
46
Issue
10
Language
English
OCDE Knowledge area
Reumatología
Scopus EID
2-s2.0-85072758050
PubMed ID
Source
Journal of Rheumatology
ISSN of the container
0315162X
Sources of information: Directorio de Producción Científica Scopus