Failure to achieve lupus low disease activity state (LLDAS) six months after diagnosis is associated with early damage accrual in Caucasian patients with systemic lupus erythematosus
Abstract Background The aim was to assess the attainability and outcome of the lupus low disease activity state (LLDAS) in the early stages of systemic lupus erythematosus (SLE). Methods LLDAS prevalence was evaluated at 6 (T1) and 18 (T2) months after diagnosis and treatment initiation (T0) in a mo...
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| Format: | Article |
| Language: | English |
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BMC
2017-11-01
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| Series: | Arthritis Research & Therapy |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13075-017-1451-5 |
| _version_ | 1819034638704705536 |
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| author | Matteo Piga Alberto Floris Giulia Cappellazzo Elisabetta Chessa Mattia Congia Alessandro Mathieu Alberto Cauli |
| author_facet | Matteo Piga Alberto Floris Giulia Cappellazzo Elisabetta Chessa Mattia Congia Alessandro Mathieu Alberto Cauli |
| author_sort | Matteo Piga |
| collection | DOAJ |
| description | Abstract Background The aim was to assess the attainability and outcome of the lupus low disease activity state (LLDAS) in the early stages of systemic lupus erythematosus (SLE). Methods LLDAS prevalence was evaluated at 6 (T1) and 18 (T2) months after diagnosis and treatment initiation (T0) in a monocentric cohort of 107 (median disease duration 9.7 months) prospectively followed Caucasian patients with SLE. Reasons for failure to achieve LLDAS were also investigated. Multivariate models were built to identify factors associated with lack of LLDAS achievement and to investigate the relationship between LLDAS and Systemic Lupus International Collaboration Clinics (SLICC)/Damage Index (SDI) accrual. Results There were 47 (43.9%) patients in LLDAS at T1 and 48 (44.9%) at T2. The most frequent unmet LLDAS criterion was prednisolone dose >7.5 mg/day (83% of patients with no LLDAS at T1). Disease manifestations with the lowest remission rate during follow up were increased anti-double-stranded DNA (persistently present in 85.7% and 67.5% of cases at T1 and T2, respectively), low serum complement fractions (73.2% and 66.3%) and renal abnormalities (46.4% and 28.6%). Renal involvement at T0 was significantly associated with failure to achieve LLDAS both at T1 (OR 7.8, 95% CI 1.4–43.4; p = 0.019) and T2 (OR 3.9, 95% CI 1.4–10.6; p = 0.008). Presence of any organ damage (SDI ≥1) at T2 was significantly associated with lack of LLDAS at T1 (OR 5.0, 95% CI 1.5–16.6; p = 0.009) and older age at diagnosis (OR 1.05 per year, 95% CI 1.01–1.09; p = 0.020). Conclusion LLDAS is a promising treatment target in the early stages of SLE, being attainable and negatively associated with damage accrual, but it fit poorly to patients with renal involvement. |
| first_indexed | 2024-12-21T07:36:55Z |
| format | Article |
| id | doaj.art-f11b131a263248e283f79b7ef52cd847 |
| institution | Directory Open Access Journal |
| issn | 1478-6362 |
| language | English |
| last_indexed | 2024-12-21T07:36:55Z |
| publishDate | 2017-11-01 |
| publisher | BMC |
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| series | Arthritis Research & Therapy |
| spelling | doaj.art-f11b131a263248e283f79b7ef52cd8472022-12-21T19:11:26ZengBMCArthritis Research & Therapy1478-63622017-11-011911910.1186/s13075-017-1451-5Failure to achieve lupus low disease activity state (LLDAS) six months after diagnosis is associated with early damage accrual in Caucasian patients with systemic lupus erythematosusMatteo Piga0Alberto Floris1Giulia Cappellazzo2Elisabetta Chessa3Mattia Congia4Alessandro Mathieu5Alberto Cauli6Chair of Rheumatology and Rheumatology Unit, University Clinic and AOU of CagliariChair of Rheumatology and Rheumatology Unit, University Clinic and AOU of CagliariChair of Rheumatology and Rheumatology Unit, University Clinic and AOU of CagliariChair of Rheumatology and Rheumatology Unit, University Clinic and AOU of CagliariChair of Rheumatology and Rheumatology Unit, University Clinic and AOU of CagliariChair of Rheumatology and Rheumatology Unit, University Clinic and AOU of CagliariChair of Rheumatology and Rheumatology Unit, University Clinic and AOU of CagliariAbstract Background The aim was to assess the attainability and outcome of the lupus low disease activity state (LLDAS) in the early stages of systemic lupus erythematosus (SLE). Methods LLDAS prevalence was evaluated at 6 (T1) and 18 (T2) months after diagnosis and treatment initiation (T0) in a monocentric cohort of 107 (median disease duration 9.7 months) prospectively followed Caucasian patients with SLE. Reasons for failure to achieve LLDAS were also investigated. Multivariate models were built to identify factors associated with lack of LLDAS achievement and to investigate the relationship between LLDAS and Systemic Lupus International Collaboration Clinics (SLICC)/Damage Index (SDI) accrual. Results There were 47 (43.9%) patients in LLDAS at T1 and 48 (44.9%) at T2. The most frequent unmet LLDAS criterion was prednisolone dose >7.5 mg/day (83% of patients with no LLDAS at T1). Disease manifestations with the lowest remission rate during follow up were increased anti-double-stranded DNA (persistently present in 85.7% and 67.5% of cases at T1 and T2, respectively), low serum complement fractions (73.2% and 66.3%) and renal abnormalities (46.4% and 28.6%). Renal involvement at T0 was significantly associated with failure to achieve LLDAS both at T1 (OR 7.8, 95% CI 1.4–43.4; p = 0.019) and T2 (OR 3.9, 95% CI 1.4–10.6; p = 0.008). Presence of any organ damage (SDI ≥1) at T2 was significantly associated with lack of LLDAS at T1 (OR 5.0, 95% CI 1.5–16.6; p = 0.009) and older age at diagnosis (OR 1.05 per year, 95% CI 1.01–1.09; p = 0.020). Conclusion LLDAS is a promising treatment target in the early stages of SLE, being attainable and negatively associated with damage accrual, but it fit poorly to patients with renal involvement.http://link.springer.com/article/10.1186/s13075-017-1451-5Systemic lupus erythematosusDisease activityOutcomes research |
| spellingShingle | Matteo Piga Alberto Floris Giulia Cappellazzo Elisabetta Chessa Mattia Congia Alessandro Mathieu Alberto Cauli Failure to achieve lupus low disease activity state (LLDAS) six months after diagnosis is associated with early damage accrual in Caucasian patients with systemic lupus erythematosus Arthritis Research & Therapy Systemic lupus erythematosus Disease activity Outcomes research |
| title | Failure to achieve lupus low disease activity state (LLDAS) six months after diagnosis is associated with early damage accrual in Caucasian patients with systemic lupus erythematosus |
| title_full | Failure to achieve lupus low disease activity state (LLDAS) six months after diagnosis is associated with early damage accrual in Caucasian patients with systemic lupus erythematosus |
| title_fullStr | Failure to achieve lupus low disease activity state (LLDAS) six months after diagnosis is associated with early damage accrual in Caucasian patients with systemic lupus erythematosus |
| title_full_unstemmed | Failure to achieve lupus low disease activity state (LLDAS) six months after diagnosis is associated with early damage accrual in Caucasian patients with systemic lupus erythematosus |
| title_short | Failure to achieve lupus low disease activity state (LLDAS) six months after diagnosis is associated with early damage accrual in Caucasian patients with systemic lupus erythematosus |
| title_sort | failure to achieve lupus low disease activity state lldas six months after diagnosis is associated with early damage accrual in caucasian patients with systemic lupus erythematosus |
| topic | Systemic lupus erythematosus Disease activity Outcomes research |
| url | http://link.springer.com/article/10.1186/s13075-017-1451-5 |
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