Session Information
Date: Sunday, October 21, 2018
Title: Systemic Lupus Erythematosus – Clinical Poster I: Clinical Manifestations and Comorbidity
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Prolonged Remission and Influence on Damage Accrual and Infection for Patients with Systemic Lupus Erythematosus: a Multi-center Cohort Study from China
Ziqian Wang1, Jiuliang Zhao1, Yanhong Wang2, Mengtao Li1, Xiaofeng Zeng1 and CSTAR co-authors
1Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No.1 shuaifuyuan, Beijing 100730, China.
2Department of Epidemiology and Bio-statistics (YW), Institute of Basic Medical Sciences, China Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China.
Abstract
Background/Purpose:
To study how many patients with Systemic Lupus Erythematosus (SLE) maintained remission in CSTAR (Chinese SLE Treatment and Research group) registry cohort, and further explore the influence of remission on organ damage accumulation and infection, which is the major cause of death in our cohort.
Methods:
Patient recruitment started from April 2009 to February 2010. They were followed up yearly at clinic. Baseline data mainly included demography, clinical manifestations, activity (SLEDAI-2K), organ damages (SLLIC/Damage Index). Logistic regression model was performed to study the effect of remission on damage and severe infection occurrence.
Results:
A total of 687 patients were regularly followed up with intact data. Among them, 357 patients never experienced disease flare during follow-up. Finally, 74 (10.8%) patients developed into prolonged remission off steroids for at least 1 year, and 23 (3.3%) patients of them were treated without steroids since enrolled. 137 (19.9%) patients achieved persistent remission with prednisone ¡Ü5mg/d at the endpoint. Logistic regression analysis showed that disease flare was associated with new damage [OR 2.385, p <0.001] and severe infection [OR 1.833, p =0.006].
Conclusion:
Prolonged remission should be a treating target for Chinese SLE patients and it can be achieved for nearly half of the patients now. To avoid disease flare may reduce the probability of new damage and severe infection. Appropriate strategies to maintain remission deserve more investigations in future.
Key words: Systemic lupus erythematosus, Remission, Organ damage, Infection
Table 1 Baseline Characteristics for Patients
|
Remission with pred ¡Ü5mg/d n=211 (%) |
With flare N=330 (%) |
|
|
Male |
7.58 |
9.10 |
|
Serositis |
21.8 |
16.4 |
|
Lupus nephritis |
52.6 |
58.8 |
|
Hematological involvement |
43.6 |
52.1 |
|
Interstitial lung disease |
3.32 |
5.45 |
|
Pulmonary arterial hypertension |
1.90 |
2.42 |
|
Neuropsychiatric involvemnt |
7.58 |
7.58 |
|
Anti-dsDNA |
55.0 |
56.7 |
|
Anti-SM |
20.4 |
19.4 |
|
Anti-RNP |
13.3 |
14.5 |
|
Anti-SSA |
28.4 |
27.0 |
|
Anti-SSB |
12.3 |
10.9 |
|
Anti-rRNP |
10.4 |
14.8 |
|
APL |
31.3 |
36.7 |
|
Low completement |
57.4 |
63.9 |
|
Baseline organ damage |
15.6 |
17.3 |
To cite this abstract in AMA style:
Wang Z, ZHAO J, Wang Y, Li M, Zeng X. Prolonged Remission and Influence on Damage Accrual and Infection for Patients with Systemic Lupus Erythematosus: A Multi-Center Cohort Study from China [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/prolonged-remission-and-influence-on-damage-accrual-and-infection-for-patients-with-systemic-lupus-erythematosus-a-multi-center-cohort-study-from-china/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/prolonged-remission-and-influence-on-damage-accrual-and-infection-for-patients-with-systemic-lupus-erythematosus-a-multi-center-cohort-study-from-china/