The effect of different durations of remission on damage accrual: results from a prospective monocentric cohort of Caucasian patients. Issue 3 (24th November 2016)

• Record Type: Journal Article
• Authors: Zen, Margherita; Iaccarino, Luca; Gatto, Mariele; Bettio, Silvano; Saccon, Francesca; Ghirardello, Anna; Punzi, Leonardo; Doria, Andrea
• Is Part Of: Annals of the rheumatic diseases. Volume 76:Issue 3(2017)
• Page Start: 562
• Page End: 565
• Publication Date: 2016-11-24
• Subjects: Systemic Lupus Erythematosus -- Outcomes research -- Disease Activity; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2016-210154
• Languages: English
• ISSNs: 0003-4967

Abstract

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.