Treatments and outcomes in Chinese patients with serologically active clinically quiescent systemic lupus erythematosus: a retrospective observational study

Abstract Objective To clarify the frequency and outcome of patients with systemic lupus erythematosus (SLE) who achieved the clinical state as serologically active clinically quiescent (SACQ) and to identify factors associated with the flare of disease. Methods Clinical data of patients diagnosed as...

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Main Authors: Hong Huang, Lin Mu, Zhuoli Zhang, Dai Gao, Yanjie Hao, Wei Zhou
Format: Article
Language:English
Published: BMC 2021-10-01
Series:Arthritis Research & Therapy
Subjects:
Online Access:https://doi.org/10.1186/s13075-021-02641-5
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author Hong Huang
Lin Mu
Zhuoli Zhang
Dai Gao
Yanjie Hao
Wei Zhou
author_facet Hong Huang
Lin Mu
Zhuoli Zhang
Dai Gao
Yanjie Hao
Wei Zhou
author_sort Hong Huang
collection DOAJ
description Abstract Objective To clarify the frequency and outcome of patients with systemic lupus erythematosus (SLE) who achieved the clinical state as serologically active clinically quiescent (SACQ) and to identify factors associated with the flare of disease. Methods Clinical data of patients diagnosed as SLE and followed in Peking University First Hospital from 2009 to 2015 were retrospectively reviewed. Six hundred eighty-two patients who were followed up for more than 6 months were analyzed. SACQ was defined as an at least a 6-month period with persistent serologic activity and without clinical activity and daily dose of prednisone or equivalent were less than 7.5 mg. Serologically quiescent clinically quiescent (SQCQ) patients served as control groups. Data including demographics, initial symptoms, duration to SACQ, treatments before and after SACQ, and characteristics of the patients suffered from flare were analyzed. Results Among the 682 patients, 170 patients were SACQ (24.9%) and 187 patients were SQCQ. SQCQ patients (38.61 ± 15.08 years old) were older at baseline than SACQ patients (38.61 ± 15.08 years vs. 32.09 ± 14.35 years, p < 0.001). Of 170 SACQ patients, 32.9% experienced flare that was significantly higher than 15.5% of SQCQ patients (29/187). Corticosteroids (OR 1.323, 95% CI 1.129 to 1.550; p = 0.001) was an independent risk factor for flare, while antimalarials (OR 0.045, 95% CI 0.004 to 0.474; p = 0.010) and immunosuppressants (OR 0.332, 95% CI 0.156 to 0.706; p = 0.004) were protective factors in SACQ patients; however, only antimalarials was protective factors in SQCQ patients (OR 0.028, 95% CI 0.001 to 0.743; p = 0.033). Conclusion About one third of SLE patients with SACQ experience flare, significantly more frequent than that of patients with SQCQ. Thus, approach to prevent flare in SACQ patient is required. Maintenance therapy of hydroxychloroquine and immunosuppressant agents may be protective and beneficial treatment strategy in these patients.
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spelling doaj.art-a41ec2e2f74e4fa6a9d2ab7741b8810e2022-12-21T20:45:36ZengBMCArthritis Research & Therapy1478-63622021-10-012311910.1186/s13075-021-02641-5Treatments and outcomes in Chinese patients with serologically active clinically quiescent systemic lupus erythematosus: a retrospective observational studyHong Huang0Lin Mu1Zhuoli Zhang2Dai Gao3Yanjie Hao4Wei Zhou5Department of Rheumatology and Clinical Immunology, Peking University First HospitalDepartment of Rheumatology and Clinical Immunology, Peking University First HospitalDepartment of Rheumatology and Clinical Immunology, Peking University First HospitalDepartment of Rheumatology and Clinical Immunology, Peking University First HospitalDepartment of Rheumatology and Clinical Immunology, Peking University First HospitalDepartment of Rheumatology and Clinical Immunology, Peking University First HospitalAbstract Objective To clarify the frequency and outcome of patients with systemic lupus erythematosus (SLE) who achieved the clinical state as serologically active clinically quiescent (SACQ) and to identify factors associated with the flare of disease. Methods Clinical data of patients diagnosed as SLE and followed in Peking University First Hospital from 2009 to 2015 were retrospectively reviewed. Six hundred eighty-two patients who were followed up for more than 6 months were analyzed. SACQ was defined as an at least a 6-month period with persistent serologic activity and without clinical activity and daily dose of prednisone or equivalent were less than 7.5 mg. Serologically quiescent clinically quiescent (SQCQ) patients served as control groups. Data including demographics, initial symptoms, duration to SACQ, treatments before and after SACQ, and characteristics of the patients suffered from flare were analyzed. Results Among the 682 patients, 170 patients were SACQ (24.9%) and 187 patients were SQCQ. SQCQ patients (38.61 ± 15.08 years old) were older at baseline than SACQ patients (38.61 ± 15.08 years vs. 32.09 ± 14.35 years, p < 0.001). Of 170 SACQ patients, 32.9% experienced flare that was significantly higher than 15.5% of SQCQ patients (29/187). Corticosteroids (OR 1.323, 95% CI 1.129 to 1.550; p = 0.001) was an independent risk factor for flare, while antimalarials (OR 0.045, 95% CI 0.004 to 0.474; p = 0.010) and immunosuppressants (OR 0.332, 95% CI 0.156 to 0.706; p = 0.004) were protective factors in SACQ patients; however, only antimalarials was protective factors in SQCQ patients (OR 0.028, 95% CI 0.001 to 0.743; p = 0.033). Conclusion About one third of SLE patients with SACQ experience flare, significantly more frequent than that of patients with SQCQ. Thus, approach to prevent flare in SACQ patient is required. Maintenance therapy of hydroxychloroquine and immunosuppressant agents may be protective and beneficial treatment strategy in these patients.https://doi.org/10.1186/s13075-021-02641-5Systemic lupus erythematosusDisease activityOutcomeTreatmentClinically quiescent and serologically active
spellingShingle Hong Huang
Lin Mu
Zhuoli Zhang
Dai Gao
Yanjie Hao
Wei Zhou
Treatments and outcomes in Chinese patients with serologically active clinically quiescent systemic lupus erythematosus: a retrospective observational study
Arthritis Research & Therapy
Systemic lupus erythematosus
Disease activity
Outcome
Treatment
Clinically quiescent and serologically active
title Treatments and outcomes in Chinese patients with serologically active clinically quiescent systemic lupus erythematosus: a retrospective observational study
title_full Treatments and outcomes in Chinese patients with serologically active clinically quiescent systemic lupus erythematosus: a retrospective observational study
title_fullStr Treatments and outcomes in Chinese patients with serologically active clinically quiescent systemic lupus erythematosus: a retrospective observational study
title_full_unstemmed Treatments and outcomes in Chinese patients with serologically active clinically quiescent systemic lupus erythematosus: a retrospective observational study
title_short Treatments and outcomes in Chinese patients with serologically active clinically quiescent systemic lupus erythematosus: a retrospective observational study
title_sort treatments and outcomes in chinese patients with serologically active clinically quiescent systemic lupus erythematosus a retrospective observational study
topic Systemic lupus erythematosus
Disease activity
Outcome
Treatment
Clinically quiescent and serologically active
url https://doi.org/10.1186/s13075-021-02641-5
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