Risk of systemic lupus erythematosus flares according to autoantibody positivity at the time of diagnosis
Abstract To estimate the risk of systemic lupus erythematosus (SLE) flares based on the autoantibody positivity at the time of SLE diagnosis. This retrospective cohort study included 228 patients with newly diagnosed SLE. Clinical characteristics including autoantibody positivity at the time of diag...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-02-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-29772-w |
| _version_ | 1797864819629490176 |
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| author | Oh Chan Kwon Min-Chan Park |
| author_facet | Oh Chan Kwon Min-Chan Park |
| author_sort | Oh Chan Kwon |
| collection | DOAJ |
| description | Abstract To estimate the risk of systemic lupus erythematosus (SLE) flares based on the autoantibody positivity at the time of SLE diagnosis. This retrospective cohort study included 228 patients with newly diagnosed SLE. Clinical characteristics including autoantibody positivity at the time of diagnosis of SLE were reviewed. Flares were defined as a new British Isles Lupus Assessment Group (BILAG) A score or BILAG B score for at least one organ system. Multivariable Cox regression analyses were performed to estimate the risk of flares according to autoantibody positivity. Anti-dsDNA, anti-Sm, anti-U1RNP, anti-Ro, and anti-La antibodies (Abs) were positive in 50.0%, 30.7%, 42.5%, 54.8%, and 22.4% of the patients, respectively. The incidence rate of flares was 28.2/100 person-years. Multivariable Cox regression analysis, adjusted for potential confounders, revealed that anti-dsDNA Ab positivity (adjusted hazard ratio [HR]: 1.46, p = 0.037) and anti-Sm Ab positivity (adjusted HR: 1.81, p = 0.004) at the time of diagnosis of SLE were associated with higher risk of flares. To better delineate the flare risk, patients were categorized as double-negative, single-positive, double-positive for anti-dsDNA and anti-Sm Abs. Compared with double-negativity, double-positivity (adjusted HR: 3.34, p < 0.001) was associated with higher risk of flares, while anti-dsDNA Ab single-positivity (adjusted HR: 1.11, p = 0.620) or anti-Sm Ab single-positivity (adjusted HR: 1.32, p = 0.270) was not associated with higher risk of flares. Patients who are double-positive for anti-dsDNA and anti-Sm Abs at the time of the diagnosis of SLE are at higher risk of flares and may benefit from stringent monitoring and early preventive treatment. |
| first_indexed | 2024-04-09T22:58:14Z |
| format | Article |
| id | doaj.art-42983b8e40a446c080312dfff737eb9f |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-09T22:58:14Z |
| publishDate | 2023-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-42983b8e40a446c080312dfff737eb9f2023-03-22T11:06:29ZengNature PortfolioScientific Reports2045-23222023-02-0113111010.1038/s41598-023-29772-wRisk of systemic lupus erythematosus flares according to autoantibody positivity at the time of diagnosisOh Chan Kwon0Min-Chan Park1Division of Rheumatology, Department of Internal Medicine, Yonsei University College of MedicineDivision of Rheumatology, Department of Internal Medicine, Yonsei University College of MedicineAbstract To estimate the risk of systemic lupus erythematosus (SLE) flares based on the autoantibody positivity at the time of SLE diagnosis. This retrospective cohort study included 228 patients with newly diagnosed SLE. Clinical characteristics including autoantibody positivity at the time of diagnosis of SLE were reviewed. Flares were defined as a new British Isles Lupus Assessment Group (BILAG) A score or BILAG B score for at least one organ system. Multivariable Cox regression analyses were performed to estimate the risk of flares according to autoantibody positivity. Anti-dsDNA, anti-Sm, anti-U1RNP, anti-Ro, and anti-La antibodies (Abs) were positive in 50.0%, 30.7%, 42.5%, 54.8%, and 22.4% of the patients, respectively. The incidence rate of flares was 28.2/100 person-years. Multivariable Cox regression analysis, adjusted for potential confounders, revealed that anti-dsDNA Ab positivity (adjusted hazard ratio [HR]: 1.46, p = 0.037) and anti-Sm Ab positivity (adjusted HR: 1.81, p = 0.004) at the time of diagnosis of SLE were associated with higher risk of flares. To better delineate the flare risk, patients were categorized as double-negative, single-positive, double-positive for anti-dsDNA and anti-Sm Abs. Compared with double-negativity, double-positivity (adjusted HR: 3.34, p < 0.001) was associated with higher risk of flares, while anti-dsDNA Ab single-positivity (adjusted HR: 1.11, p = 0.620) or anti-Sm Ab single-positivity (adjusted HR: 1.32, p = 0.270) was not associated with higher risk of flares. Patients who are double-positive for anti-dsDNA and anti-Sm Abs at the time of the diagnosis of SLE are at higher risk of flares and may benefit from stringent monitoring and early preventive treatment.https://doi.org/10.1038/s41598-023-29772-w |
| spellingShingle | Oh Chan Kwon Min-Chan Park Risk of systemic lupus erythematosus flares according to autoantibody positivity at the time of diagnosis Scientific Reports |
| title | Risk of systemic lupus erythematosus flares according to autoantibody positivity at the time of diagnosis |
| title_full | Risk of systemic lupus erythematosus flares according to autoantibody positivity at the time of diagnosis |
| title_fullStr | Risk of systemic lupus erythematosus flares according to autoantibody positivity at the time of diagnosis |
| title_full_unstemmed | Risk of systemic lupus erythematosus flares according to autoantibody positivity at the time of diagnosis |
| title_short | Risk of systemic lupus erythematosus flares according to autoantibody positivity at the time of diagnosis |
| title_sort | risk of systemic lupus erythematosus flares according to autoantibody positivity at the time of diagnosis |
| url | https://doi.org/10.1038/s41598-023-29772-w |
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