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Risk and Factors associated with disease manifestations in systemic lupus erythematosus – lupus nephritis (RIFLE-LN): a ten-year risk prediction strategy derived from a cohort of 1652 patients
OBJECTIVES: Lupus nephritis (LN) remains one of the most severe manifestations in patients with systemic lupus erythematosus (SLE). Onset and overall LN risk among SLE patients remains considerably difficult to predict. Utilizing a territory-wide longitudinal cohort of over 10 years serial follow-up...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10311203/ https://www.ncbi.nlm.nih.gov/pubmed/37398664 http://dx.doi.org/10.3389/fimmu.2023.1200732 |
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author | Chan, Shirley C. W. Wang, Yong-Fei Yap, Desmond Y. H. Chan, Tak Mao Lau, Yu Lung Lee, Pamela P. W. Lai, Wai Ming Ying, Shirley K. Y. Tse, Niko K. C. Leung, Alexander M. H. Mok, Chi Chiu Lee, Ka Lai Li, Teresa W. L. Tsang, Helen H. L. Yeung, Winnie W. Y. Ho, Carmen T. K. Wong, Raymond W. S. Yang, Wanling Lau, Chak Sing Li, Philip H. |
author_facet | Chan, Shirley C. W. Wang, Yong-Fei Yap, Desmond Y. H. Chan, Tak Mao Lau, Yu Lung Lee, Pamela P. W. Lai, Wai Ming Ying, Shirley K. Y. Tse, Niko K. C. Leung, Alexander M. H. Mok, Chi Chiu Lee, Ka Lai Li, Teresa W. L. Tsang, Helen H. L. Yeung, Winnie W. Y. Ho, Carmen T. K. Wong, Raymond W. S. Yang, Wanling Lau, Chak Sing Li, Philip H. |
author_sort | Chan, Shirley C. W. |
collection | PubMed |
description | OBJECTIVES: Lupus nephritis (LN) remains one of the most severe manifestations in patients with systemic lupus erythematosus (SLE). Onset and overall LN risk among SLE patients remains considerably difficult to predict. Utilizing a territory-wide longitudinal cohort of over 10 years serial follow-up data, we developed and validated a risk stratification strategy to predict LN risk among Chinese SLE patients – Risk and Factors associated with disease manifestations in systemic Lupus Erythematosus – Lupus Nephritis (RIFLE-LN). METHODS: Demographic and longitudinal data including autoantibody profiles, clinical manifestations, major organ involvement, LN biopsy results and outcomes were documented. Association analysis was performed to identify factors associated with LN. Regression modelling was used to develop a prediction model for 10-year risk of LN and thereafter validated. RESULTS: A total of 1652 patients were recruited: 1382 patients were assigned for training and validation of the RIFLE-LN model; while 270 were assigned for testing. The median follow-up duration was 21 years. In the training and validation cohort, 845 (61%) of SLE patients developed LN. Cox regression and log rank test showed significant positive association between male sex, age of SLE onset and anti-dsDNA positivity. These factors were thereafter used to develop RIFLE-LN. The algorithm was tested in 270 independent patients and showed good performance (AUC = 0·70). CONCLUSION: By using male sex, anti-dsDNA positivity, age of SLE onset and SLE duration; RIFLE-LN can predict LN among Chinese SLE patients with good performance. We advocate its potential utility in guiding clinical management and disease monitoring. Further validation studies in independent cohorts are required. |
format | Online Article Text |
id | pubmed-10311203 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-103112032023-07-01 Risk and Factors associated with disease manifestations in systemic lupus erythematosus – lupus nephritis (RIFLE-LN): a ten-year risk prediction strategy derived from a cohort of 1652 patients Chan, Shirley C. W. Wang, Yong-Fei Yap, Desmond Y. H. Chan, Tak Mao Lau, Yu Lung Lee, Pamela P. W. Lai, Wai Ming Ying, Shirley K. Y. Tse, Niko K. C. Leung, Alexander M. H. Mok, Chi Chiu Lee, Ka Lai Li, Teresa W. L. Tsang, Helen H. L. Yeung, Winnie W. Y. Ho, Carmen T. K. Wong, Raymond W. S. Yang, Wanling Lau, Chak Sing Li, Philip H. Front Immunol Immunology OBJECTIVES: Lupus nephritis (LN) remains one of the most severe manifestations in patients with systemic lupus erythematosus (SLE). Onset and overall LN risk among SLE patients remains considerably difficult to predict. Utilizing a territory-wide longitudinal cohort of over 10 years serial follow-up data, we developed and validated a risk stratification strategy to predict LN risk among Chinese SLE patients – Risk and Factors associated with disease manifestations in systemic Lupus Erythematosus – Lupus Nephritis (RIFLE-LN). METHODS: Demographic and longitudinal data including autoantibody profiles, clinical manifestations, major organ involvement, LN biopsy results and outcomes were documented. Association analysis was performed to identify factors associated with LN. Regression modelling was used to develop a prediction model for 10-year risk of LN and thereafter validated. RESULTS: A total of 1652 patients were recruited: 1382 patients were assigned for training and validation of the RIFLE-LN model; while 270 were assigned for testing. The median follow-up duration was 21 years. In the training and validation cohort, 845 (61%) of SLE patients developed LN. Cox regression and log rank test showed significant positive association between male sex, age of SLE onset and anti-dsDNA positivity. These factors were thereafter used to develop RIFLE-LN. The algorithm was tested in 270 independent patients and showed good performance (AUC = 0·70). CONCLUSION: By using male sex, anti-dsDNA positivity, age of SLE onset and SLE duration; RIFLE-LN can predict LN among Chinese SLE patients with good performance. We advocate its potential utility in guiding clinical management and disease monitoring. Further validation studies in independent cohorts are required. Frontiers Media S.A. 2023-06-15 /pmc/articles/PMC10311203/ /pubmed/37398664 http://dx.doi.org/10.3389/fimmu.2023.1200732 Text en Copyright © 2023 Chan, Wang, Yap, Chan, Lau, Lee, Lai, Ying, Tse, Leung, Mok, Lee, Li, Tsang, Yeung, Ho, Wong, Yang, Lau and Li https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Immunology Chan, Shirley C. W. Wang, Yong-Fei Yap, Desmond Y. H. Chan, Tak Mao Lau, Yu Lung Lee, Pamela P. W. Lai, Wai Ming Ying, Shirley K. Y. Tse, Niko K. C. Leung, Alexander M. H. Mok, Chi Chiu Lee, Ka Lai Li, Teresa W. L. Tsang, Helen H. L. Yeung, Winnie W. Y. Ho, Carmen T. K. Wong, Raymond W. S. Yang, Wanling Lau, Chak Sing Li, Philip H. Risk and Factors associated with disease manifestations in systemic lupus erythematosus – lupus nephritis (RIFLE-LN): a ten-year risk prediction strategy derived from a cohort of 1652 patients |
title | Risk and Factors associated with disease manifestations in systemic lupus erythematosus – lupus nephritis (RIFLE-LN): a ten-year risk prediction strategy derived from a cohort of 1652 patients |
title_full | Risk and Factors associated with disease manifestations in systemic lupus erythematosus – lupus nephritis (RIFLE-LN): a ten-year risk prediction strategy derived from a cohort of 1652 patients |
title_fullStr | Risk and Factors associated with disease manifestations in systemic lupus erythematosus – lupus nephritis (RIFLE-LN): a ten-year risk prediction strategy derived from a cohort of 1652 patients |
title_full_unstemmed | Risk and Factors associated with disease manifestations in systemic lupus erythematosus – lupus nephritis (RIFLE-LN): a ten-year risk prediction strategy derived from a cohort of 1652 patients |
title_short | Risk and Factors associated with disease manifestations in systemic lupus erythematosus – lupus nephritis (RIFLE-LN): a ten-year risk prediction strategy derived from a cohort of 1652 patients |
title_sort | risk and factors associated with disease manifestations in systemic lupus erythematosus – lupus nephritis (rifle-ln): a ten-year risk prediction strategy derived from a cohort of 1652 patients |
topic | Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10311203/ https://www.ncbi.nlm.nih.gov/pubmed/37398664 http://dx.doi.org/10.3389/fimmu.2023.1200732 |
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