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- Title
Effect of Disease Activity on Organ Damage Progression in Systemic Lupus Erythematosus: University of Toronto Lupus Clinic Cohort.
- Authors
Urowitz, Murray B.; Gladman, Dafna D.; Ibañez, Dominique; Su, Jiandong; Mursleen, Sara; Sayani, Amyn; Ross Terres, Jorge Alfonso; Iczkovitz, Sandra
- Abstract
<bold>Objective: </bold>To examine the role of disease activity on organ damage over 5 years in patients with active systemic lupus erythematosus (SLE) despite standard of care.<bold>Methods: </bold>This analysis of the University of Toronto Lupus Clinic cohort assessed organ damage [measured by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)] in patients with active SLE [SLE Disease Activity Index 2000 (SLEDAI-2K) ≥ 6], using Cox proportional time-independent hazard models. Subgroup analyses were conducted in patients with SLEDAI-2K 6 or 7, 8 or 9, and ≥ 10 at baseline, and in the overall study population by steroid dose at study entry (< 7.5 vs ≥ 7.5 mg/day).<bold>Results: </bold>Among the overall study population (n = 649), SDI progression was observed in 209 (32.2%) patients over the 5-year follow-up period. Mean SDI change in patients with a score > 0 was generally consistent across all SLEDAI-2K subgroups. Multivariable analyses identified age at study start (HR 1.03, P < 0.0001), steroid dose (HR 2.03, P < 0.0001), immunosuppressants (HR 1.44, P = 0.021), and SLEDAI-2K (subgroup analyses HR 1.64-2.03, P = 0.0017 to < 0.0001) as the greatest risk factors for SDI progression, while a study start date after the year 2000 had a protective effect on SDI progression compared with a start date prior to the year 2000 (HR 0.65, P = 0.0004).<bold>Conclusion: </bold>Patients within the higher SLEDAI-2K subgroups at study entry or receiving high doses of steroids were more likely to have organ damage progression. INSET: 67.
- Subjects
ANATOMICAL organ diseases; SYSTEMIC lupus erythematosus; COHORT analysis; UNIVERSITY of Toronto; DISEASE progression
- Publication
Journal of Rheumatology, 2021, Vol 48, Issue 1, p67
- ISSN
0315-162X
- Publication type
journal article
- DOI
10.3899/jrheum.190259