SMART-SLE: serology monitoring and repeat testing in systemic lupus erythematosus-an analysis of anti-double-stranded DNA monitoring.
Rheumatology (Oxford)
; 63(2): 525-533, 2024 Feb 01.
Article
en En
| MEDLINE
| ID: mdl-37208196
ABSTRACT
OBJECTIVE:
Disease activity monitoring in SLE includes serial measurement of anti-double stranded-DNA (dsDNA) antibodies, but in patients who are persistently anti-dsDNA positive, the utility of repeated measurement is unclear. We investigated the usefulness of serial anti-dsDNA testing in predicting flare in SLE patients who are persistently anti-dsDNA positive.METHODS:
Data were analysed from patients in a multinational longitudinal cohort with known anti-dsDNA results from 2013 to 2021. Patients were categorized based on their anti-dsDNA results as persistently negative, fluctuating or persistently positive. Cox regression models were used to examine longitudinal associations of anti-dsDNA results with flare.RESULTS:
Data from 37 582 visits of 3484 patients were analysed. Of the patients 1029 (29.5%) had persistently positive anti-dsDNA and 1195 (34.3%) had fluctuating results. Anti-dsDNA expressed as a ratio to the normal cut-off was associated with the risk of subsequent flare, including in the persistently positive cohort (adjusted hazard ratio [HR] 1.56; 95% CI 1.30, 1.87; P < 0.001) and fluctuating cohort (adjusted HR 1.46; 95% CI 1.28, 1.66), both for a ratio >3. Both increases and decreases in anti-dsDNA more than 2-fold compared with the previous visit were associated with increased risk of flare in the fluctuating cohort (adjusted HR 1.33; 95% CI 1.08, 1.65; P = 0.008) and the persistently positive cohort (adjusted HR 1.36; 95% CI 1.08, 1.71; P = 0.009).CONCLUSION:
Absolute value and change in anti-dsDNA titres predict flares, including in persistently anti-dsDNA positive patients. This indicates that repeat monitoring of dsDNA has value in routine testing.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Anticuerpos Antinucleares
/
Lupus Eritematoso Sistémico
Tipo de estudio:
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Rheumatology (Oxford)
Asunto de la revista:
REUMATOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Australia