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Effect of Disease Activity on Organ Damage Progression in Systemic Lupus Erythematosus: University of Toronto Lupus Clinic Cohort.
Urowitz, Murray B; Gladman, Dafna D; Ibañez, Dominique; Su, Jiandong; Mursleen, Sara; Sayani, Amyn; Ross Terres, Jorge Alfonso; Iczkovitz, Sandra.
Afiliação
  • Urowitz MB; This study was funded by GlaxoSmithKline Inc. (GSK; study number 201390). M.B. Urowitz, MD, D.D. Gladman, MD, D. Ibañez, MSc, J. Su, MSc, Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada; 2S. Mursleen, MSc, A. Sayani, PhD, S. Iczkovitz, MSc, Glax
  • Gladman DD; This study was funded by GlaxoSmithKline Inc. (GSK; study number 201390). M.B. Urowitz, MD, D.D. Gladman, MD, D. Ibañez, MSc, J. Su, MSc, Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada; 2S. Mursleen, MSc, A. Sayani, PhD, S. Iczkovitz, MSc, Glax
  • Ibañez D; This study was funded by GlaxoSmithKline Inc. (GSK; study number 201390). M.B. Urowitz, MD, D.D. Gladman, MD, D. Ibañez, MSc, J. Su, MSc, Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada; 2S. Mursleen, MSc, A. Sayani, PhD, S. Iczkovitz, MSc, Glax
  • Su J; This study was funded by GlaxoSmithKline Inc. (GSK; study number 201390). M.B. Urowitz, MD, D.D. Gladman, MD, D. Ibañez, MSc, J. Su, MSc, Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada; 2S. Mursleen, MSc, A. Sayani, PhD, S. Iczkovitz, MSc, Glax
  • Mursleen S; This study was funded by GlaxoSmithKline Inc. (GSK; study number 201390). M.B. Urowitz, MD, D.D. Gladman, MD, D. Ibañez, MSc, J. Su, MSc, Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada; 2S. Mursleen, MSc, A. Sayani, PhD, S. Iczkovitz, MSc, Glax
  • Sayani A; This study was funded by GlaxoSmithKline Inc. (GSK; study number 201390). M.B. Urowitz, MD, D.D. Gladman, MD, D. Ibañez, MSc, J. Su, MSc, Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada; 2S. Mursleen, MSc, A. Sayani, PhD, S. Iczkovitz, MSc, Glax
  • Ross Terres JA; This study was funded by GlaxoSmithKline Inc. (GSK; study number 201390). M.B. Urowitz, MD, D.D. Gladman, MD, D. Ibañez, MSc, J. Su, MSc, Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada; 2S. Mursleen, MSc, A. Sayani, PhD, S. Iczkovitz, MSc, Glax
  • Iczkovitz S; This study was funded by GlaxoSmithKline Inc. (GSK; study number 201390). M.B. Urowitz, MD, D.D. Gladman, MD, D. Ibañez, MSc, J. Su, MSc, Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada; 2S. Mursleen, MSc, A. Sayani, PhD, S. Iczkovitz, MSc, Glax
J Rheumatol ; 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32238510
ABSTRACT

OBJECTIVE:

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.

METHODS:

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).

RESULTS:

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).

CONCLUSION:

Patients within the higher SLEDAI-2K subgroups at study entry or receiving high doses of steroids were more likely to have organ damage progression.
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Estudo observacional / Estudo prognóstico / Fatores de risco Idioma: Inglês Ano de publicação: 2020 Tipo de documento: Artigo

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Estudo observacional / Estudo prognóstico / Fatores de risco Idioma: Inglês Ano de publicação: 2020 Tipo de documento: Artigo