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Artigo Produção Nacional Revisado por pares
BIBTEX RIS

Remission and Low Disease Activity Status (LDAS) protect lupus patients from damage occurrence: data from a multiethnic, multinational Latin American Lupus Cohort (GLADEL)

2017; BMJ; Volume: 76; Issue: 12 Linguagem: Inglês

10.1136/annrheumdis-2017-211814

ISSN

1468-2060

Autores

Manuel F. Ugarte‐Gil, Daniel Wojdyla, Guillermo Pons‐Estel, Luís J. Catoggio, Cristina Drenkard, Judith Sarano, Guillermo Berbotto, Eduardo Ferreira Borba, Emília Inoue Sato, João Carlos Tavares Brenol, Óscar Osío Uribe, Luis Alberto Ramírez Gómez, Marlene Guibert-Toledano, Loreto Massardo, Mario H. Cardiel, Luis H. Silveira, R. Chacón, Graciela S. Alarcón, Bernardo A. Pons‐Estel,

Tópico(s)

Rheumatoid Arthritis Research and Therapies

Resumo

To evaluate disease activity statuses' (DAS') impact on systemic lupus erythematosus (SLE) outcomes.Four DAS were defined: remission off-therapy: SLE Disease Activity Index (SLEDAI)=0, no prednisone or immunosuppressive drugs (IS); remission on-therapy: SLEDAI=0, prednisone ≤5 mg/day and/or IS (maintenance); low (L) DAS: SLEDAI ≤4, prednisone ≤7.5 mg/day and/or IS (maintenance); non-optimally controlled: SLEDAI >4 and/or prednisone >7.5 mg/day and/or IS (induction). Antimalarials were allowed in all. Predefined outcomes were mortality, new damage (increase of at least one Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index (SDI) point) and severe new damage (increase of at least 3 SDI points). Univariable and multivariable Cox regression models were performed to define the impact of DAS, as time-dependent variable, on these outcomes.1350 patients were included, 79 died during follow-up, 606 presented new and 177 severe new damage. In multivariable analyses, remission (on/off-therapy) was associated with a lower risk of new (HR 0.60; 95% CI 0.43 to 0.85), and of severe new damage (HR 0.32; 95% CI 0.15 to 0.68); low disease activity status (LDAS) was associated with a lower risk of new damage (HR 0.66; 95% CI 0.48 to 0.93) compared with non-optimally controlled. No significant effect on mortality was observed.Remission was associated with a lower risk of new and severe new damage; LDAS with a lower risk of new damage after adjusting for other damage confounders.

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