Cargando…
Predictors of severe lupus flare: a prospective follow-up study
BACKGROUND: Flare-up of systemic lupus erythematosus (SLE) is a common characteristic that could have deleterious effects on patients’ outcome and survival. The aim of this study was to identify the predictors of severe lupus flare. METHODS: 120 patients with SLE were enrolled and followed-up for 23...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10207823/ https://www.ncbi.nlm.nih.gov/pubmed/37221627 http://dx.doi.org/10.1186/s41927-023-00333-y |
_version_ | 1785046538806886400 |
---|---|
author | Fatemi, Alimohammad Keivani-Boroujeni, Elaheh Smiley, Abbas |
author_facet | Fatemi, Alimohammad Keivani-Boroujeni, Elaheh Smiley, Abbas |
author_sort | Fatemi, Alimohammad |
collection | PubMed |
description | BACKGROUND: Flare-up of systemic lupus erythematosus (SLE) is a common characteristic that could have deleterious effects on patients’ outcome and survival. The aim of this study was to identify the predictors of severe lupus flare. METHODS: 120 patients with SLE were enrolled and followed-up for 23 months. Demographic, clinical manifestations, laboratory parameters and disease activity were recorded at each visit. In addition, presence of severe lupus flare at each visit was evaluated by using the Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLE disease activity index (SLEDAI) flare composite index. Predictors of severe lupus flare were obtained by backward logistic regression analyses. Predictors of SLEDAI were obtained by backward linear regression analyses. RESULTS: During the follow-up period, 47 patients had at least one episode of severe lupus flare. Mean (SD) age of patients with severe flare versus no flare was 31.7 (7.89) and 38.3 (8.24) years, respectively (P = 0.001). Ten (62.5%) out of 16 males and 37 (35.5%) out of 104 females had severe flare (P = 0.04). History of lupus nephritis (LN) was recorded in 76.5% and 44% of patients with severe flare and no severe flare, respectively (P = 0.001). Thirty-five (29.2%) patients with high anti-double-stranded DNA (anti-ds-DNA antibody) and 12 (10%) with negative anti-ds-DNA antibody had severe lupus flare (P = 0.02). By multivariable logistic regression analysis, younger age (OR = 0.87, 95% CI 0.80–0.94, P = 0.0001), history of LN (OR = 4.66, 95% CI 1.55–14.002, P = 0.006) and high SLEDAI at the first visit (OR = 1.19, 95% CI 1.026–1.38) were the main predictors of flare. When severe lupus flare after the first visit was used as the outcome variable, similar findings were observed but, SLEDAI, although left among the final predictors in the model, was not significant. SLEDAIs in future visits were mainly predicted by Anti-ds-DNA antibody, 24-h urine protein and arthritis at the first visit. CONCLUSION: SLE patients with younger age, history of previous LN or high baseline SLEDAI, may need closer monitoring and follow up. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41927-023-00333-y. |
format | Online Article Text |
id | pubmed-10207823 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-102078232023-05-25 Predictors of severe lupus flare: a prospective follow-up study Fatemi, Alimohammad Keivani-Boroujeni, Elaheh Smiley, Abbas BMC Rheumatol Research BACKGROUND: Flare-up of systemic lupus erythematosus (SLE) is a common characteristic that could have deleterious effects on patients’ outcome and survival. The aim of this study was to identify the predictors of severe lupus flare. METHODS: 120 patients with SLE were enrolled and followed-up for 23 months. Demographic, clinical manifestations, laboratory parameters and disease activity were recorded at each visit. In addition, presence of severe lupus flare at each visit was evaluated by using the Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLE disease activity index (SLEDAI) flare composite index. Predictors of severe lupus flare were obtained by backward logistic regression analyses. Predictors of SLEDAI were obtained by backward linear regression analyses. RESULTS: During the follow-up period, 47 patients had at least one episode of severe lupus flare. Mean (SD) age of patients with severe flare versus no flare was 31.7 (7.89) and 38.3 (8.24) years, respectively (P = 0.001). Ten (62.5%) out of 16 males and 37 (35.5%) out of 104 females had severe flare (P = 0.04). History of lupus nephritis (LN) was recorded in 76.5% and 44% of patients with severe flare and no severe flare, respectively (P = 0.001). Thirty-five (29.2%) patients with high anti-double-stranded DNA (anti-ds-DNA antibody) and 12 (10%) with negative anti-ds-DNA antibody had severe lupus flare (P = 0.02). By multivariable logistic regression analysis, younger age (OR = 0.87, 95% CI 0.80–0.94, P = 0.0001), history of LN (OR = 4.66, 95% CI 1.55–14.002, P = 0.006) and high SLEDAI at the first visit (OR = 1.19, 95% CI 1.026–1.38) were the main predictors of flare. When severe lupus flare after the first visit was used as the outcome variable, similar findings were observed but, SLEDAI, although left among the final predictors in the model, was not significant. SLEDAIs in future visits were mainly predicted by Anti-ds-DNA antibody, 24-h urine protein and arthritis at the first visit. CONCLUSION: SLE patients with younger age, history of previous LN or high baseline SLEDAI, may need closer monitoring and follow up. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41927-023-00333-y. BioMed Central 2023-05-24 /pmc/articles/PMC10207823/ /pubmed/37221627 http://dx.doi.org/10.1186/s41927-023-00333-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Fatemi, Alimohammad Keivani-Boroujeni, Elaheh Smiley, Abbas Predictors of severe lupus flare: a prospective follow-up study |
title | Predictors of severe lupus flare: a prospective follow-up study |
title_full | Predictors of severe lupus flare: a prospective follow-up study |
title_fullStr | Predictors of severe lupus flare: a prospective follow-up study |
title_full_unstemmed | Predictors of severe lupus flare: a prospective follow-up study |
title_short | Predictors of severe lupus flare: a prospective follow-up study |
title_sort | predictors of severe lupus flare: a prospective follow-up study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10207823/ https://www.ncbi.nlm.nih.gov/pubmed/37221627 http://dx.doi.org/10.1186/s41927-023-00333-y |
work_keys_str_mv | AT fatemialimohammad predictorsofseverelupusflareaprospectivefollowupstudy AT keivaniboroujenielaheh predictorsofseverelupusflareaprospectivefollowupstudy AT smileyabbas predictorsofseverelupusflareaprospectivefollowupstudy |