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

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dc.citation.issue12
dc.citation.volume76
dc.contributor.authorFrancisco Ugarte-Gil, Manuel
dc.contributor.authorWojdyla, Daniel
dc.contributor.authorPons-Estel, Guillermo J.
dc.contributor.authorCatoggio, Luis J.
dc.contributor.authorDrenkard, Cristina
dc.contributor.authorSarano, Judith
dc.contributor.authorBerbotto, Guillermo A.
dc.contributor.authorBorba, Eduardo F.
dc.contributor.authorSato, Emilia Inoue [UNIFESP]
dc.contributor.authorTavares Brenol, Joao C.
dc.contributor.authorUribe, Oscar
dc.contributor.authorRamirez Gomez, Luis A.
dc.contributor.authorGuibert-Toledano, Marlene
dc.contributor.authorMassardo, Loreto
dc.contributor.authorCardiel, Mario H.
dc.contributor.authorSilveira, Luis H.
dc.contributor.authorChacon-Diaz, Rosa
dc.contributor.authorAlarcon, Graciela S.
dc.contributor.authorPons-Estel, Bernardo A.
dc.coverageLondon
dc.date.accessioned2020-09-01T13:21:10Z
dc.date.available2020-09-01T13:21:10Z
dc.date.issued2017
dc.description.abstractObjective To evaluate disease activity statuses' (DAS') impact on systemic lupus erythematosus (SLE) outcomes. Materials and methods 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. Results 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. Conclusions 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.en
dc.description.affiliationHosp Guillermo Almenara Irigoyen, Dept Rheumatol, Lima 33, Peru
dc.description.affiliationUniv Cient Sur, Lima, Peru
dc.description.affiliationGLADEL Consultant, Rosario, Santa Fe, Argentina
dc.description.affiliationHosp Clin Barcelona, Dept Autoimmune Dis, Barcelona, Spain
dc.description.affiliationCREAR, Rosario, Santa Fe, Argentina
dc.description.affiliationHosp Italiano Buenos Aires, Serv Clin Med, Secc Reumatol, Buenos Aires, DF, Argentina
dc.description.affiliationHosp Italiano Buenos Aires, Escuela Med, Inst Univ, Buenos Aires, DF, Argentina
dc.description.affiliationFdn Dr Pedro M Catoggio Progreso Reumatol, Buenos Aires, DF, Argentina
dc.description.affiliationEmory Sch Med, Div Rheumatol, Dept Med, Atlanta, GA USA
dc.description.affiliationInst Invest Med Alfredo Lanari, Serv Inmunol, Buenos Aires, DF, Argentina
dc.description.affiliationHosp Escuela Eva Peron, Serv Reumatol, Granadero Baigorria, Argentina
dc.description.affiliationUniv Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Div Rheumatol, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Hosp Sao Paulo, Escola Paulista Med UNIFESP, Disciplina Reumatol, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Rio Grande do Sul, Hosp Clin Porto Alegre, Dept Internal Med, Div Rheumatol, Porto Alegre, RS, Brazil
dc.description.affiliationUniv Antioquia, Fac Med, Grp Reumatol, Hosp Univ San Vicente Fdn, Medellin, Colombia
dc.description.affiliationCtr Invest Med Quirurg, Serv Reumatol, Havana, Cuba
dc.description.affiliationUniv San Sebastian, Fac Med, Santiago, Chile
dc.description.affiliationCtr Invest Clin Morelia, Morelia, Michoacan, Mexico
dc.description.affiliationInst Nacl Cardiol Ignacio Chavez, Dept Reumatol, Mexico City, DF, Mexico
dc.description.affiliationHosp Univ Caracas, Ctr Nacl Enfermedades Reumat, Serv Reumatol, Caracas, Venezuela
dc.description.affiliationUniv Alabama Birmingham, Sch Med, Dept Med, Div Clin Immunol & Rheumatol, Birmingham, AL USA
dc.description.affiliationUnifespUniv Fed Sao Paulo, Hosp Sao Paulo, Escola Paulista Med UNIFESP, Disciplina Reumatol, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent2071-2074
dc.identifierhttp://dx.doi.org/10.1136/annrheumdis-2017-211814
dc.identifier.citationAnnals Of The Rheumatic Diseases. London, v. 76, n. 12, p. 2071-2074, 2017.
dc.identifier.doi10.1136/annrheumdis-2017-211814
dc.identifier.issn0003-4967
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/58101
dc.identifier.wosWOS:000417061500024
dc.language.isoeng
dc.publisherBmj Publishing Group
dc.relation.ispartofAnnals Of The Rheumatic Diseases
dc.rightsAcesso restrito
dc.titleRemission and Low Disease Activity Status (LDAS) protect lupus patients from damage occurrence: data from a multiethnic, multinational Latin American Lupus Cohort (GLADEL)en
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