Longitudinal associations of flare and damage accrual in patients with systemic lupus erythematosus
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...
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BMJ Publishing Group
2025-01-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/12/1/e001363.full |
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| author | 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 |
| author_facet | 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 |
| author_sort | Rangi Kandane-Rathnayake |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-b5998a0a4a9143bebdec2c4162fe695d |
| institution | Kabale University |
| issn | 2053-8790 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
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| series | Lupus Science and Medicine |
| spelling | doaj-art-b5998a0a4a9143bebdec2c4162fe695d2025-01-21T08:30:12ZengBMJ Publishing GroupLupus Science and Medicine2053-87902025-01-0112110.1136/lupus-2024-001363Longitudinal associations of flare and damage accrual in patients with systemic lupus erythematosusRangi Kandane-Rathnayake0Sang-Cheol Bae1Zhanguo Li2Shereen Oon3Vera Golder4Mandana Nikpour5Masayoshi Harigai6Zhuoli Zhang7Eric Morand8Chak Sing Lau9Worawit Louthrenoo10Alberta Hoi11Sandra Navarra12Sean O’Neill13Shue-Fen Luo14Yanjie Hao15Yasuhiro Katsumata16Dominique Milea17Aisha Lateef18Laniyati Hamijoyo19Sargunan Sockalingam20Madelynn Chan21Jiacai Cho22Leonid Zamora23Fiona Goldblatt24Yeong-Jian Jan Wu25Xiaomeng Xu26Aldo A Navarro Rojas27Rheumatology Research Group, Centre for Inflammatory Diseases, School of Clinical Sciences, Monash University, Clayton, Victoria, AustraliaHanyang University Institute for Rheumatology Research, Seongdong-gu, Seoul, Republic of KoreaDepartment of Rheumatology and Immunology, Peking University People`s Hospital, Beijing, ChinaDepartment of Rheumatology, St Vincent’s Hospital Melbourne, Fitzroy, Victoria, AustraliaRheumatology Research Group, Centre for Inflammatory Diseases, School of Clinical Sciences, Monash University, Clayton, Victoria, AustraliaDepartment of Rheumatology, St Vincent’s Hospital Melbourne, Fitzroy, Victoria, AustraliaDepartment of Rheumatology, Sanno Hospital, Minato-ku, Tokyo, JapanRheumatology and Immunology Department, Peking University First Hospital, Beijing, ChinaRheumatology Research Group, Centre for Inflammatory Diseases, School of Clinical Sciences, Monash University, Clayton, Victoria, AustraliaDivision of Rheumatology & Clinical Immunology, The University of Hong Kong, Pok Fu Lam, Hong KongDivision of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai, ThailandRheumatology Research Group, Centre for Inflammatory Diseases, School of Clinical Sciences, Monash University, Clayton, Victoria, AustraliaSection of Rheumatology, University of Santo Tomas Hospital, Manila, PhilippinesThe University of Sydney, Sydney, New South Wales, AustraliaDivision of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, TaiwanDepartment of Rheumatology, St Vincent’s Hospital Melbourne, Fitzroy, Victoria, AustraliaDivision of Rheumatology, Department of Internal Medicine, Tokyo Women`s Medical University School of Medicine, Shinjuku-ku, Tokyo, JapanValue, Evidence & Outcomes, GSK, SingaporeDepartment of Medicine, Woodlands Health, SingaporeDivision of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Padjadjaran University, Bandung, IndonesiaDepartment of Medicine, Faculty of Medicine, University Malaya Medical Center, Kuala Lumpur, MalaysiaDepartment of Rheumatology, Allergy & Immunology, Tan Tock Seng Hospital, SingaporeRheumatology Division, Department of Medicine, National University Hospital, SingaporeSection of Rheumatology, University of Santo Tomas Hospital, Manila, PhilippinesDepartment of Rheumatology, Flinders Medical Centre, Bedford Park, South Australia, AustraliaDepartment of Rheumatology, Allergy and Immunology, Keelung Chang Gung Memorial Hospital, Keelung, TaiwanValue, Evidence & Outcomes, GSK, SingaporeMedical Affairs, Greater China & Intercontinental, GSK, SingaporeObjective 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.https://lupus.bmj.com/content/12/1/e001363.full |
| spellingShingle | 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 Longitudinal associations of flare and damage accrual in patients with systemic lupus erythematosus Lupus Science and Medicine |
| title | Longitudinal associations of flare and damage accrual in patients with systemic lupus erythematosus |
| title_full | Longitudinal associations of flare and damage accrual in patients with systemic lupus erythematosus |
| title_fullStr | Longitudinal associations of flare and damage accrual in patients with systemic lupus erythematosus |
| title_full_unstemmed | Longitudinal associations of flare and damage accrual in patients with systemic lupus erythematosus |
| title_short | Longitudinal associations of flare and damage accrual in patients with systemic lupus erythematosus |
| title_sort | longitudinal associations of flare and damage accrual in patients with systemic lupus erythematosus |
| url | https://lupus.bmj.com/content/12/1/e001363.full |
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