Frequency and Predictors of Attaining the Lupus Low Disease Activity State (LLDAS) in a Multinational SLE Cohort from the Asia Pacific

Vera Golder¹, Rangi Kandane-Rathnayake², Alberta Y. Hoi³, Molla Huq⁴, Worawit Louthrenoo⁵, Yuan An⁶, Zhanguo Li⁶, Shue Fen Luo⁷, Sargunan Sockalingam⁸, Chak Sing Lau⁹, Alfred Lee¹⁰, Mo Yin Mok¹⁰, Aisha Lateef¹¹, Kate Franklyn³, Susan Morton¹², Sandra V. Navarra¹³, Leonid Zamora¹³, Yeong-Jian Wu⁷, Laniyati Hamijoyo¹⁴, Madelynn Chan¹⁵, Sean O'Neill¹⁶, Fiona Goldblatt¹⁷, Eric F Morand³, Mandana Nikpour¹⁸ and Asia Pacific Lupus Collaboration, ¹Southern Clinical School, Centre for Inflammatory Diseases, Monash University, Melbourne, Australia, ²Rheumatology, Monash University, Melbourne, Australia, ³Centre for Inflammatory Diseases, Monash University, Melbourne, Australia, ⁴Department of Medicine (Rheumatology), Melbourne University, Melbourne, Australia, ⁵Division of Rheumatology, Department of Internal Medicine, Chiang Mai University, Chiang Mai, Thailand, ⁶Peking University People's Hospital, Beijing, China, ⁷Chang Gung University, Taoyuan County, Taiwan, ⁸University of Malaya, Kuala Lumpur, Malaysia, ⁹Univ Dept of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong, ¹⁰Queen Mary Hospital, Hong Kong, Hong Kong, ¹¹Medicine/Rheumatology, National University Health System, Singapore, Singapore, ¹²Monash Health, Melbourne, Australia, ¹³Rheumatology, University of Santo Tomas Hospital, Manila, Philippines, ¹⁴University of Padjadjaran, Bandung, Indonesia, ¹⁵Tan Tock Seng Hospital, Singapore, Singapore, ¹⁶University of New South Wales, Sydney, Australia, ¹⁷Royal Adelaide Hospital, Adelaide, Australia, ¹⁸Melbourne University, Melbourne, Australia

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Disease Activity and systemic lupus erythematosus (SLE)

Session Information

Date: Monday, November 14, 2016

Title: Systemic Lupus Erythematosus – Clinical Aspects and Treatment - Poster II: Damage Accrual and Quality of Life

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Systemic lupus erythematosus (SLE) is a chronic heterogeneous disease with considerable burden from disease activity and damage. A novel clinical treatment target in the form of the Lupus Low Disease Activity State (LLDAS) has been recently reported (Franklyn et al, Ann Rheum Dis, 2015), with retrospective validation showing that time spent in LLDAS translated to reduced damage accrual. The objectives of this study were to describe the frequency and identify the predictors of attaining LLDAS in a large multinational cohort of patients with SLE.

Methods: Data were collected at the baseline visit of SLE patients enrolled in a longitudinal study in 12 centres across the Asia Pacific. Data were analysed cross-sectionally against the recently published definition of LLDAS, and the frequency and characteristics associated with LLDAS attainment were determined. Stepwise multivariable logistic regression was used to determine predictors of LLDAS.

Results: Of the 1846 patients assessed, criteria for LLDAS were met by 44%. Data revealed that patients with shorter disease duration were less likely to be in LLDAS (OR 0.31, 95% CI 0.19-0.49, p<0.001). Likewise, patients with a history of discoid rash (OR 0.66, 95% CI 0.49-0.89, p=0.006), renal disease (OR 0.60, 95% CI 0.48-0.75, p<0.001), or who had elevated double stranded DNA (OR 0.65, 95% CI 0.53-0.81, p<0.001) or hypocomplementaemia (OR 0.52, 95% CI 0.40-0.67, p<0.001) were less likely to be in LLDAS. When countries were compared, higher national social wealth (OR 1.57, 95% CI 1.25-1.98, p<0.001) as measured by the Gross Domestic Product per capita was positively associated with LLDAS.

Conclusion: In a large multinational SLE cohort, the lupus low disease activity state is observed in less than half of patients at a single point in time. Disease duration and phenotype, as well as national social wealth, are predictive of LLDAS.

Disclosure: V. Golder, None; R. Kandane-Rathnayake, None; A. Y. Hoi, None; M. Huq, None; W. Louthrenoo, None; Y. An, None; Z. Li, None; S. F. Luo, None; S. Sockalingam, None; C. S. Lau, None; A. Lee, None; M. Y. Mok, None; A. Lateef, None; K. Franklyn, None; S. Morton, None; S. V. Navarra, None; L. Zamora, None; Y. J. Wu, None; L. Hamijoyo, None; M. Chan, None; S. O'Neill, None; F. Goldblatt, None; E. F. Morand, None; M. Nikpour, None.

To cite this abstract in AMA style:

Golder V, Kandane-Rathnayake R, Hoi AY, Huq M, Louthrenoo W, An Y, Li Z, Luo SF, Sockalingam S, Lau CS, Lee A, Mok MY, Lateef A, Franklyn K, Morton S, Navarra SV, Zamora L, Wu YJ, Hamijoyo L, Chan M, O'Neill S, Goldblatt F, Morand EF, Nikpour M. Frequency and Predictors of Attaining the Lupus Low Disease Activity State (LLDAS) in a Multinational SLE Cohort from the Asia Pacific [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/frequency-and-predictors-of-attaining-the-lupus-low-disease-activity-state-lldas-in-a-multinational-sle-cohort-from-the-asia-pacific/. Accessed .

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