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Ann Rheum Dis. 2017 Mar;76(3):562-565. doi: 10.1136/annrheumdis-2016-210154. Epub 2016 Nov 24.

The effect of different durations of remission on damage accrual: results from a prospective monocentric cohort of Caucasian patients.

Author information

1
Division of Rheumatology, Department of Medicine, University of Padova, Padova, Italy.

Abstract

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.

KEYWORDS:

Disease Activity; Outcomes research; Systemic Lupus Erythematosus

PMID:
27884821
DOI:
10.1136/annrheumdis-2016-210154
[Indexed for MEDLINE]

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