期刊
ARTHRITIS & RHEUMATOLOGY
卷 70, 期 11, 页码 1790-1795出版社
WILEY
DOI: 10.1002/art.40571
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类别
资金
- NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases) [AR-R01-43727, AR-R01-69572]
ObjectiveMethodsOne objective in the treatment of systemic lupus erythematosus (SLE) disease activity is to reduce long-term rates of organ damage. We undertook this study to analyze data from a large clinical SLE cohort to compare patients achieving different levels of disease activity with respect to rates of long-term damage. We analyzed data from 1,356 SLE patients in the Hopkins Lupus Cohort, followed up quarterly, with 77,105 person-months observed from 1987 to 2016. Three outcome measures were considered: clinical remission with no treatment, clinical remission on treatment, and lupus low disease activity state (LLDAS). ResultsConclusionPatients achieved LLDAS in 50% of their follow-up months. They achieved clinical remission with no treatment or clinical remission on treatment in only 13% and 27%, respectively, of their follow-up visits. The rates of damage consistently declined with increased percentage of prior time in either LLDAS or clinical remission on treatment. Spending a short proportion of prior time (<25%) in clinical remission on treatment was associated with a relatively low rate of damage compared to never achieving that condition (1.01 events per 10 person-years versus 1.82 events per 10 person-years; rate ratio 0.54, P < 0.0001). Those patients who experienced LLDAS at least 50% of the time had relatively low rates of damage (rate ratio 0.39-0.47, P < 0.0001). LLDAS is an easier target to achieve than clinical remission on treatment and results in reduced risk of long-term damage. However, even a small percentage of time in clinical remission on treatment was associated with reduced damage.
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