Comparison of Remission and Lupus Low Disease Activity State in Damage Prevention in a United States Systemic Lupus Erythematosus Cohort.
Comparison of Remission and Lupus Low Disease Activity State in Damage Prevention in a United States Systemic Lupus Erythematosus Cohort.
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DOI：
10.1002/art.40571
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发表时间：
2018-11
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通讯作者：
Magder LS
中科院分区：
文献类型：
--
作者：
Petri M;Magder LS
SLE疾病活动性治疗的一个目的是降低长期器官损伤率。我们分析了来自一个大型临床SLE队列的数据，以比较达到不同疾病活动水平的患者的长期损害率。我们分析了霍普金斯狼疮队列中1,356例SLE患者的数据，每季度随访一次，从1987年到2016年观察了77,105人月。考虑了三个结果指标：未治疗的临床缓解、治疗中的临床缓解和狼疮低疾病活动状态（LLDAS）。患者在50%的随访中实现了LLDAS，而他们分别在13%和27%的随访访视中实现了未治疗的临床缓解或治疗中的临床缓解。损伤率随着LLDAS或治疗临床缓解中既往时间百分比的增加而持续下降。花费较短比例的先前时间进行临床缓解治疗（<25%的时间）与相对较低的损害率相关（1.01/10人年，而从未达到该条件的患者为1.82/10人年，RR=0.54，p<0.0001）。那些至少有50%的时间发生LLDAS的患者的损伤率相对较低（RR在0.39至0.47之间，p<0.0001）。LLDAS是比临床缓解更容易实现的目标，并可降低长期损害的风险。然而，即使是很小比例的治疗临床缓解时间也与损害减少相关。
One objective in the treatment of SLE disease activity is to reduce long-term rates of organ damage. We analyzed data from a large clinical SLE cohort to compare patients achieving different levels of disease activity with respect to rates of long-term damage. We analyzed data from 1,356 SLE patients in the Hopkins Lupus Cohort, followed quarterly, with 77,105 person-months observed from 1987 to 2016. Three outcome measures were considered: Clinical Remission with No Treatment, Clinical Remission On Treatment, and Lupus Low Disease Activity State (LLDAS). Patients achieved LLDAS in 50% of their follow-up while they achieved Clinical Remission with No Treatment, or Clinical Remission On Treatment in only 13% and 27% of their follow-up visits, respectively. The rates of damage consistently declined as the percentage of prior time in either LLDAS or Clinical Remission On Treatment increased. Spending a short proportion of prior time in Clinical Remission On Treatment (<25% of time) was associated with a relatively low rate of damage (1.01 per 10 person-years vs. 1.82 events per 10 person years for those never in achieving that condition, RR=0.54, p<0.0001). Those patients who experienced LLDAS at least 50% of the time had relatively low rates of damage (RR between 0.39 to 0.47, p<0.0001). LLDAS is an easier target to achieve than Clinical Remission On Treatment and results in reduced risk of long-term damage. However, even a small percentage of time in Clinical Remission On Treatment was associated with reduced damage.
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作者：
Petri, Michelle;Orbai, Ana-Maria;Alarcon, Graciela S.;Gordon, Caroline;Merrill, Joan T.;Fortin, Paul R.;Bruce, Ian N.;Isenberg, David;Wallace, Daniel J.;Nived, Ola;Sturfelt, Gunnar;Ramsey-Goldman, Rosalind;Bae, Sang-Cheol;Hanly, John G.;Sanchez-Guerrero, Jorge;Clarke, Ann;Aranow, Cynthia;Manzi, Susan;Urowitz, Murray;Gladman, Dafna;Kalunian, Kenneth;Costner, Melissa;Werth, Victoria P.;Zoma, Asad;Bernatsky, Sasha;Ruiz-Irastorza, Guillermo;Khamashta, Munther A.;Jacobsen, Soren;Buyon, Jill P.;Maddison, Peter;Dooley, Mary Anne;van vollenhoven, Ronald F.;Ginzler, Ellen;Stoll, Thomas;Peschken, Christine;Jorizzo, Joseph L.;Callen, Jeffrey P.;Lim, S. Sam;Fessler, Barri J.;Inanc, Murat;Kamen, Diane L.;Rahman, Anisur;Steinsson, Kristjan;Franks, Andrew G., Jr.;Sigler, Lisa;Hameed, Suhail;Fang, Hong;Ngoc Pham;Brey, Robin;Weisman, Michael H.;McGwin, Gerald, Jr.;Magder, Laurence S.
通讯作者：
Magder, Laurence S.
影响因子：
27.4
作者：
van Vollenhoven, Ronald;Voskuyl, Alexandre;Ward, Michael
通讯作者：
Ward, Michael
影响因子：
5
作者：
Magder, Laurence S.;Petri, Michelle
通讯作者：
Petri, Michelle
影响因子：
27.4
作者：
Morand, Eric F.;Trasieva, Teodora;Tummala, Raj
通讯作者：
Tummala, Raj
影响因子：
--
作者：
BOMBARDIER, C;GLADMAN, DD;CHANG, CH
通讯作者：
CHANG, CH