Evolution of disease burden over five years in a multicenter inception systemic lupus erythematosus cohort
Evolution of disease burden over five years in a multicenter inception systemic lupus erythematosus cohort
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DOI：
10.1002/acr.20648
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发表时间：
2012-01-01
影响因子：
4.7
通讯作者：
Aranow, C.
中科院分区：
文献类型：
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作者：
Urowitz, M. B.;Gladman, D. D.;Aranow, C.
目的探讨系统性红斑狼疮（SLE）早期患者的疾病活动性、损害和主要自身抗体的发生情况。系统性狼疮国际合作诊所（SLICC）国际研究网络，包括来自11个国家的27个中心，根据标准化方案每年对SLE患者的初始队列进行随访。在这些患者中，对298例患者进行了至少5年的随访，构成了研究人群。使用SLE疾病活动指数2000（SLEDAI-2K）评估疾病活动性，使用SLICC/美国流变学损伤指数（SDI）评估损伤。抗核抗体（ANA），抗DNA，抗心磷脂抗体（ACL）水平和狼疮抗凝剂每年进行评估。描述性统计和重复测量一般线性模型被用来评估SLEDAI-2K和SDI随着时间的推移之间的白人和非白人。在298例患者中，87%为女性，55%为白色，12%为非洲裔美国人，14%为亚洲人，16%为西班牙裔，2%被归类为“其他”。“在登记时，平均年龄为35.3岁，平均SLEDAI-2K评分为5.9，平均病程为5.5个月。平均SLEDAI-2K评分在第一年下降，然后保持较低水平。与非白人相比，白人每年的SLEDAI-2K评分显着降低。平均SDI评分在5年内逐渐增加，白人和非白人之间没有显着差异。正如预期的那样，ANA阳性率高，抗DNA阳性率相对较低，并且在5年内都有所增加。虽然狼疮抗凝物在5年内略有增加，但aCL阳性并没有增加。新诊断患者的疾病活动在前5年减少，而损害增加。抗体阳性在此期间运行变量课程。
Objective We describe disease activity, damage, and the accrual of key autoantibodies in an inception systemic lupus erythematosus (SLE) cohort.Methods. The Systemic Lupus International Collaborating Clinics (SLICC) International Research Network, comprising 27 centers from 11 countries, has followed an inception cohort of SLE patients yearly according to a standardized protocol. Of these patients, 298 were followed for a minimum of 5 years and constitute the study population. Disease activity was assessed using the SLE Disease Activity Index 2000 (SLEDAI-2K) and damage was assessed using the SLICC/American College of Rheumatology Damage Index (SDI). Antinuclear antibody (ANA), anti-DNA, and anticardiolipin antibody (aCL) levels and lupus anticoagulant were assessed yearly. Descriptive statistics were generated and repeated-measures general linear models were used to evaluate SLEDAI-2K and SDI over time between whites and nonwhites.Results. Of the 298 patients, 87% were women, 55% were white, 12% were African American, 14% were Asian, 16% were Hispanic, and 2% were categorized as "other." At enrollment, the mean age was 35.3 years, the mean SLEDAI-2K score was 5.9, and the mean disease duration was 5.5 months. Mean SLEDAI-2K scores decreased in the first year and then remained low. SLEDAI-2K scores were significantly lower at each year in whites compared to nonwhites. Mean SDI scores increased progressively over 5 years; there was no significant difference between whites and nonwhites. As expected, ANA positivity was high and anti-DNA positivity was relatively low at enrollment, and both increased over 5 years. Although lupus anticoagulant increased slightly over 5 years, aCL positivity did not.Conclusion. Disease activity in newly diagnosed patients decreases over their first 5 years, while damage increases. Antibody positivity ran variable courses over this period.