METHODS: We included patients from a multicentre longitudinal cohort (recruited between May 1, 2013, and Dec 31, 2019) with active SLE (SLEDAI-2K ≥6) coinciding with an abnormality in at least one of 13 routine laboratory tests, at a visit designated as baseline. At 12 months, we analysed associations between thresholds of improvement in individual laboratory test results, measured as continuous variables, and five clinical outcomes using logistic regression. Primary outcomes were damage accrual and lupus low disease activity state (LLDAS), and secondary outcomes were modified SLE responder index (mSRI), physician global assessment (PGA) improvement of at least 0·3, and flare.
FINDINGS: We included 1525 patients (1415 [93%] women and 110 [7%] men, 1328 [87%] Asian ethnicity) in separate subsets for each laboratory test. The strongest associations with LLDAS and damage protection were seen with improvements in proteinuria (complete response: adjusted odds ratio [OR] 62·48, 95% CI 18·79-208·31 for LLDAS, OR 0·22, 95% CI 0·10-0·49 for damage accrual), albumin (complete response: adjusted OR 6·46, 95% CI 2·20-18·98 for LLDAS, OR 0·42, 95% CI 0·20-1·22 for damage accrual), haemoglobin (complete response: adjusted OR 1·97, 95% CI 1·09-3·53 for LLDAS, OR 0·33, 95% CI 0·15-0·71 for damage accrual), erythrocyte sedimentation rate (complete response: adjusted OR 1·71, 95% CI 1·10-2·67 for LLDAS, OR 0·53, 95% CI 0·30-0·94 for damage accrual), and platelets (complete response: adjusted OR 4·82, 95% CI 1·54-15·07 for LLDAS, OR 0·49, 95% CI 0·20-1·19 for damage accrual). Improvement in serological tests were mainly associated with PGA and mSRI. White cell and lymphocyte count improvements were least predictive.
INTERPRETATION: Improvements in several routine laboratory tests correspond with clinical outcomes in SLE over 12 months. Tests with the strongest associations were discrepant with laboratory tests included in current trial endpoints, and associations were observed across a range of improvement thresholds including incomplete resolution. These findings suggest the need to revise the use of laboratory test results in SLE trial endpoints.
FUNDING: Abbvie.
METHODS: The data in this study were presented based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Using scientific databases and web search engines including Scopus, Ebscohost, Web of Science, PubMed, and Google Scholar, researchers collected studies from the published literature. Only 26 of the 84 articles satisfied all the inclusion criteria and were thus included in the systematic review. The quality of each study was determined using the PEDro scale. The scores for 26 studies range between three and six.
RESULTS: Core training can improve soccer players' skill-related physical fitness, including their power, speed, balance, and agility.
CONCLUSION: The core is the anatomic and functional center of the body as well as its "engine." All movements emanate from the center of the body and are transmitted to the extremities. The core muscles differ from the limb muscles because they frequently cocontract, thus making the torso hard to the point whereby all the muscles work together to become synergists. Theoretically, a strong core permits the passage of force from the lower body to the upper body with minimal energy loss in the torso. Based on the 26 studies, this review suggests that core training should be incorporated into the daily training sessions of soccer players, with a minimum frequency and length of 15 min per training session, twice per week, for 4 weeks.
SYSTEMATIC REVIEW REGISTRATION: https://inplasy.com, identifier INPLASY202290045.