Comparison Of Attainment And Protective Effects Of Lupus Low Disease Activity State In Patients With Newly Diagnosed Versus Established SLE

Golder V 1 , Kandane-Rathnayake R 2 , Louthrenoo W 3 , Chen YH 4 , Cho J 5 , Lateef A 6 Show all authors , Hamijoyo L 7 , Luo SF 8 , Wu YJ 9 , Navarra SV 10 , Zamora L 11 , Li Z 12 , Sockalingam S 13 , Katsumata Y 14 , Harigai M 15 , Hao Y 16 , Zhang Z 17 , Basnayake B 18 , Chan M 19 , Kikuchi J 20 , Takeuchi T 21 , Bae SC 22 , Oon S 23 , O'Neill S 24 , Goldblatt F 25 , Ng KPL 26 , Law A 27 , Tugnet N 28 , Kumar S 29 , Tee C 30 , Tee M 31 , Ohkubo N 32 , Tanaka Y 33 , Lau CS 34 , Nikpour M 35 , Hoi A 36 , Morand EF 37 , For the Asia-Pacific Lupus Collaboration

Affiliations 

  • 1 Vera Golder - Associate Professor, MBBS, PhD; Monash University, Australia
  • 2 Rangi Kandane-Rathnayake - PhD; Monash University, Australia
  • 3 Worawit Louthrenoo - Professor, MD; Faculty of Medicine, Chiang Mai University, Thailand
  • 4 Yi-Hsing Chen - MD; Taichung Veterans General Hospital, Taichung, Taiwan
  • 5 Jiacai Cho - MBBS; National University Hospital, Singapore
  • 6 Aisha Lateef - MBBS; National University Hospital, Singapore
  • 7 Laniyati Hamijoyo - MD; University of Padjadjaran, Indonesia
  • 8 Shue-Fen Luo - Professor, MD; Chang Gung Memorial Hospital, Taiwan
  • 9 Yeong-Jian J Wu - MD; Chang Gung Memorial Hospital, Taiwan
  • 10 Sandra V. Navarra - Professor, MD; University of Santo Tomas Hospital, Philippines
  • 11 Leonid Zamora - MD; University of Santo Tomas Hospital, Philippines
  • 12 Zhanguo Li - Professor, MD; People's Hospital Peking University Health Sciences Centre, China
  • 13 Sargunan Sockalingam - Professor, MBBS; University of Malaya, Malaysia
  • 14 Yasuhiro Katsumata - MD; Tokyo Women's Medical University, Tokyo, Japan
  • 15 Masayoshi Harigai - Professor, MD; Tokyo Women's Medical University, Tokyo, Japan
  • 16 Yanjie Hao - MD; Peking University First Hospital, Beijing, China
  • 17 Zhuoli Zhang - Professor, MD; Peking University First Hospital, Beijing, China
  • 18 BMDB Basnayake - MBBS; Teaching Hospital, Kandy, Sri Lanka
  • 19 Madelynn Chan - MBBS; Tan Tock Seng Hospital, Singapore
  • 20 Jun Kikuchi - MD; Keio University, Tokyo, Japan
  • 21 Tsutomu Takeuchi - Professor, MD; Keio University, Tokyo, and Saitama Medical University, Saitama, Japan
  • 22 Sang-Cheol Bae - Professor, MD; Hanyang University Hospital for Rheumatic Diseases, Hanyang University Institute for Rheumatology Research, and Hanyang University Institute of Bioscience and Biotechnology, Seoul, South Korea
  • 23 Shereen Oon, - MBBS, PhD; Department of Medicine, The University of Melbourne at St Vincent's Hospital, Fitzroy, Victoria, Australia
  • 24 Sean O'Neill - Associate Professor, BMed, PhD; University of New South Wales and Ingham Institute of Applied Medical Research, Australia
  • 25 Fiona Goldblatt - MBBS, PhD; Royal Adelaide Hospital and Flinders Medical Centre, Australia
  • 26 Kristine (Pek Ling) Ng - MBBS; Waitemata District Health Board, Auckland, New Zealand
  • 27 Annie Law - MBBS; Singapore General Hospital, Singapore
  • 28 Nicola Tugnet - MBCHB; Auckland District Health Board, Auckland, New Zealand
  • 29 Sunil Kumar - MBBS; Middlemore Hospital, Auckland, New Zealand
  • 30 Cherica Tee - MD; University of the Philippines, Philippines
  • 31 Michael Tee - Professor, MD; University of the Philippines, Philippines
  • 32 Naoaki Ohkubo - MD; University of Occupational and Environmental Health, Kitakyushu, Japan
  • 33 Yoshiya Tanaka - Professor, MD; University of Occupational and Environmental Health, Kitakyushu, Japan
  • 34 Chak Sing Lau - Professor, MD; University of Hong Kong, Hong Kong
  • 35 Mandana Nikpour- Professor, MBBS, PhD; The University of Sydney, NSW, Australia
  • 36 Alberta Hoi - Associate Professor, MBBS, PhD; Monash University, Australia
  • 37 Eric F. Morand - Professor, MBBS, PhD; Monash University, Australia
J Rheumatol, 2024 Mar 15.
PMID: 38490668 DOI: 10.3899/jrheum.2023-0900

Abstract

OBJECTIVE: To assess whether Lupus Low Disease Activity State (LLDAS) attainment is associated with favourable outcomes in patients with recent onset SLE.

METHODS: Data from a 13-country longitudinal SLE cohort were collected prospectively between 2013 and 2020. An inception cohort was defined based on disease duration <1 year at enrolment. Patient characteristics between inception and non-inception cohorts were compared. Survival analyses were performed to examine the association between LLDAS attainment and damage accrual and flare.

RESULTS: Of the total 4,106 patients, 680 (16%) were recruited within 1 year of SLE diagnosis (inception cohort). Compared to the non-inception cohort, inception cohort patients were significantly younger, had higher disease activity, used more glucocorticoids, but had less organ damage at enrolment. Significantly fewer inception cohort patients were in LLDAS at enrolment than the non-inception cohort (29.6% vs. 52.3%, p<0.001), but three quarters of both groups achieved LLDAS at least once during follow-up. Limiting analysis only to patients not in LLDAS at enrolment, inception cohort patients were 60% more likely to attain LLDAS (HR = 1.37 (95%CI: 1.16-1.61), p<0.001) than non-inception cohort patients and attained LLDAS significantly faster. LLDAS attainment was significantly protective against flare in both the inception and non-inception cohorts. A total of 88 (13.6%) inception cohort patients accrued damage during a median 2.2 years follow-up.

CONCLUSION: LLDAS attainment is protective from flare in recent onset SLE. Significant protection from damage accrual was not observed, due to low rates of damage accrual in the first years after SLE diagnosis.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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