Baixo estado de atividade da doença e avaliação de dano permanente em pacientes ambulatoriais com lúpus eritematoso sistêmico
DOI:
https://doi.org/10.24220/2318-0897v32a2023e5507Keywords:
Patient damage, Inflammation, Systemic Lupus ErythematosusAbstract
Objective
Verify the association between low disease activity and damage accrual in Systemic Lupus Erythematosus patients.
Methods
We evaluated 60 patients following the Rheumatology Out patient Clinic with American College of Rheumatology and European League Against Rheumatism of Systemic Lupus Erythematosus diagnostic criteria. We evaluated clinical and demographic data like gender, age, and disease duration. We evaluated disease activity using the Systemic Lupus Erythematosus Low disease activity score, and damage accrual we evaluated using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index for systemic lupus erythematosus. The Chi-Square test realized statistical analysis, and a level of 0.05 was considered significant.
Results
On 60 patients studied, we found lupus low disease activity state in 45 (75%) and 15 (25%) were in disease activity. Concerning damage accrual, we found that 11 (42.3%) had damage, and 40 (66,6%) did not have damage. Five patients with damage did not have disease activity, and 40 with no activity did not have damage. Of patients with disease activity, 11 we found with damage, and no damage was found in nine. Females predominate in this population with 98.3% of patients; the mean age was 43.4 years old, and the mean disease duration was 12.8 years. The statistical analysis results showed an association between low disease activity and no damage accrual in SLE patients (p<0.005).
Conclusion
Our results demonstrated an association between low disease activity and no damage accrual in systemic lupus erythematosus patients.
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References
Bouali H, Gilkeson G. New therapies and preventive strategies to treat and minimize damage in lupus. Curr Rheumatol Rep. 2005;7(6):457-62. https://doi.org/10.1007/s11926-005-0052-5 DOI: https://doi.org/10.1007/s11926-005-0052-5
Arnaud L, Tektonidou MG. Long-term outcomes in systemic lupus erythematosus: trends over time and major contributors. Rheumatology (Oxford). 2020;59(Suppl5):29-38. https://doi.org/10.1093/rheumatology/keaa382 DOI: https://doi.org/10.1093/rheumatology/keaa382
Franklyn K, Lau CS, Navarra SV, Louthrenoo W, Lateef A, Hamijoyo L, et al. Definition and initial validation of a Lupus Low Disease Activity State (LLDAS). Ann Rheum Dis. 2016;75:1615-21. https://doi.org/10.1136/annrheumdis-2015-207726 DOI: https://doi.org/10.1136/annrheumdis-2015-207726
Golder V, Kandane-Rathnayake R, Huq M, Nim HT, Louthrenoo W, Luo SF, et al. Lupus low disease activity state as a treatment endpoint for systemic lupus erythematosus: a prospective validation study. Lancet Rheumatol. 2019;1:e95-102. https://doi.org/10.1016/52665-9913(19)30037-23 DOI: https://doi.org/10.1016/S2665-9913(19)30037-2
Ramirez GA, Canti V, Moiola L, Magnoni M, Rovere-Querini P, Coletto LA, et al. Performance of SLE responder index and lupus low disease activity state in real life: a prospective cohort study. Int J Rheum Dis. 2019;22(9):1752-61. https://doi.org/10.1111/1756-185X.13663 DOI: https://doi.org/10.1111/1756-185X.13663
Koelmeyer R, Nim HT, Nikpour M, Sun YB, Kao A, Guenther O, et al. High disease activity status suggests more severe disease and damage accrual in systemic lupus erythematosus. Lupus Sci Med. 2020;7:e000372. https://doi.org/10.1136/lupus-2019-000372 DOI: https://doi.org/10.1136/lupus-2019-000372
Tselios K, Gladman DD, Urowitz MB. How can we define low disease activity in systemic lupus erythematosus? Semin Arthritis Rheum. 2019;48:1035-40. https://doi.org/10.1016/semarthrit.2018.10.013 DOI: https://doi.org/10.1016/j.semarthrit.2018.10.013
Golder V, Tsang-A-Sjoe MWP. Treatment targets in SLE: remission and low disease activity state. Rheumatology (Oxford). 2020;59:v19-v28. https://doi.org/10.1093/rheumatology/keaa420 DOI: https://doi.org/10.1093/rheumatology/keaa420
Ugarte-Gil MF, Mendoza-Pinto C, Reátegui-Sokolova C, Pons-Estel GJ, van Vollenhoven RF, Bertsias G, et al. Achieving remission or low disease acitivity is associated with better outcomes in patients with systemic lupus erythematosus: a systematic literature review. Lupus Sci Med. 2021;8:e000542. https://doi.org/10.1136/lupus-2021-000542 DOI: https://doi.org/10.1136/lupus-2021-000542
Gladman D, Ginzler E, Goldsmith C, Fortin P, Liang M, Urowitz M, et al. The development and initial validation of the systemic lupus international collaborating clinics/American college of rheumatology damage index for systemic lupus erythematosus. Arthritis Rheum. 1996;39:363-9. https://doi.org/10.1002/art.17803903039 DOI: https://doi.org/10.1002/art.1780390303
Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-Goldman R, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Arthritis Rheumatol. 2019;71:1400-12. https://doi.org/10.1002/art.40930 DOI: https://doi.org/10.1002/art.40930
Castrejón I, Tani C, Jolly M, Huang A, Mosca M. Indices to access patients with systemic lupus erythematosus in clinical trials, long-term observational studies, and clinical care. Clin Exp Rheumatol. 2014;32(Suppl 85):S85-95.
Morand EF, Trasieva T, Berglind A, Illei GG, Tummala R. Lupus low disease activity state (LLDAS) attainment discriminates reponders in a systemic lupus erythematosus trial: post-hoc analysis of the Phase IIb MUSE trial of anifrolumab. Ann Rheum Dis. 2018;77:706-13. https://doi.org/10.1136/annrheumdis-2017-212504 DOI: https://doi.org/10.1136/annrheumdis-2017-212504
Rivest C, Lew RA, Welsing PM, Sangha O, Wright EA, Roberts WN, et al. Association between clinical factors, socioeconomic status, and organ damage in recent onset systemic lupus erythematosus. J Rheumatol. 2000;27:680-4.
Babaoglu H, Li J, Goldman D, Magder LS, Petri M. Predictors of predominant lupus low disease activity state (LLDAS-50). Lupus. 2019;28:1648-55. https://doi.org/10.1177/0961203319886028 DOI: https://doi.org/10.1177/0961203319886028
Al Sawah S, Shang X, Zhu B, Magder LS, Foster SA, Ikuni N, et al. Effect of corticosteroid use by dose on the risk of developing organ damage over time in systemic lupus erythematosus – the Hopkins Lupus Cohort. Lupus Science & Medicine. 2015;2:e000066. https://doi.org/10.11.1136/lupus-2014-000066 DOI: https://doi.org/10.1136/lupus-2014-000066
