Longitudinal associations of flare and damage accrual in patients with systemic lupus erythematosus

Bibliographic Details
Title: Longitudinal associations of flare and damage accrual in patients with systemic lupus erythematosus
Authors: Rangi Kandane-Rathnayake, Sang-Cheol Bae, Zhanguo Li, Shereen Oon, Vera Golder, Mandana Nikpour, Masayoshi Harigai, Zhuoli Zhang, Eric Morand, Chak Sing Lau, Worawit Louthrenoo, Alberta Hoi, Sandra Navarra, Sean O’Neill, Shue-Fen Luo, Yanjie Hao, Yasuhiro Katsumata, Dominique Milea, Aisha Lateef, Laniyati Hamijoyo, Sargunan Sockalingam, Madelynn Chan, Jiacai Cho, Leonid Zamora, Fiona Goldblatt, Yeong-Jian Jan Wu, Xiaomeng Xu, Aldo A Navarro Rojas
Source: Lupus Science and Medicine, Vol 12, Iss 1 (2025)
Publisher Information: BMJ Publishing Group, 2025.
Publication Year: 2025
Collection: LCC:Immunologic diseases. Allergy
Subject Terms: Immunologic diseases. Allergy, RC581-607
More Details: Objective To estimate the prevalence of organ damage (damage) and flare and to examine longitudinal associations between flares and subsequent damage accrual, in patients with systemic lupus erythematosus (SLE).Methods Patients enrolled in the Asia Pacific Lupus Collaboration cohort with ≥3 years of prospectively captured data were studied. Flares were assessed at routine visits, while damage ((Systemic Lupus International Collaborating Clinics/American College of Rheumatology) Damage Index) was assessed annually. Multivariable, multifailure survival analyses were carried out to quantify the association between flares and damage accrual.Results 1556 patients with SLE with a median (IQR) of 5.7 (3.9, 7.0) years of follow-up were studied. 39.5% (n=614) of patients had damage at enrolment, and 31.9% (n=496) accrued damage during the study observation period. The incidence of damage accrual during observation was ~58/1000 person-years. Overall, 74.1% (n=1153) of patients experienced a flare of any severity (mild/moderate or severe) at least once; 56.9% (n=885) experienced recurrent (≥2) flares. The risk of subsequent damage accrual in patients who experienced mild-to-moderate flare, after controlling for confounders, was 32% greater than in patients without flares (adjusted HR) (95% CI 1.32 (1.17 to 1.72)). The risk of damage accrual was greater if patients had severe flares (HR (95% CI) 1.58 (1.18 to 2.11)). For each additional flare, the risk of damage accrual increased by 7% (HR (95% CI) 1.07 (1.02 to 1.13)).Conclusions Flares independently increased the risk of damage accrual. Prevention of flares should be considered a necessary goal of SLE disease management to minimise permanent damage.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2053-8790
Relation: https://lupus.bmj.com/content/12/1/e001363.full; https://doaj.org/toc/2053-8790
DOI: 10.1136/lupus-2024-001363
Access URL: https://doaj.org/article/b5998a0a4a9143bebdec2c4162fe695d
Accession Number: edsdoj.b5998a0a4a9143bebdec2c4162fe695d
Database: Directory of Open Access Journals
More Details
ISSN:20538790
DOI:10.1136/lupus-2024-001363
Published in:Lupus Science and Medicine
Language:English