ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1300

Effect of Time in Clinical Remission on Damage Accrual in Systemic Lupus Erythematosus

Konstantinos Tselios1, Dafna Gladman2, Jiandong Su3 and Murray Urowitz4, 1McMaster University, Hamilton, ON, Canada, 2Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, Toronto, ON, Canada, 3University Health Network, Toronto, ON, Canada, 4Center for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto, Lupus Clinic, Toronto, ON, Canada

Meeting: ACR Convergence 2021

Keywords: clinical remission, Systemic lupus erythematosus (SLE)

  • Tweet
  • Email
  • Print
Session Information

Date: Monday, November 8, 2021

Session Title: SLE – Diagnosis, Manifestations, & Outcomes Poster III: Outcomes (1257–1303)

Session Type: Poster Session C

Session Time: 8:30AM-10:30AM

Background/Purpose: We have previously shown that prolonged clinical remission for ≥10 years is associated with significantly less damage accrual in inception patients with systemic lupus erythematosus (SLE)1. However, most lupus patients (approximately 70%) will follow a relapsing-remitting disease course pattern with greatly varying duration of remission over time. The aim of the present study was to assess the optimal duration of clinical remission in inception lupus patients and investigate its effect on damage accrual.

Methods: Inception SLE patients (time from diagnosis to first clinic visit ≤18 months) with at least 10 years of follow-up who had a relapsing-remitting pattern (≥2 distinct clinical flares over that decade) were retrieved from our long-term longitudinal database. Optimal duration of remission during the first decade of disease for the outcome of new damage accrual was established from a Logistic regression analysis (Receiver Operating Characteristic curve, ROC). Subsequently, subjects were divided into two groups according to the optimal remission duration (defined as clinical SLEDAI-2K=0 regardless of therapy). Groups were compared for percentage of patients with new damage accrual at 10 years, mean Damage Index, atherosclerotic vascular events (AVEs), osteonecrosis, osteoporosis and cumulative glucocorticoid dose. Outcomes were compared by Student’s t-test for mean values and Chi-Square test for binary variables.

Results: Two hundred patients were retrieved. Remission duration of 7.1 years yielded the best threshold based on the ROC analysis using Youden index as the selection criterion (specificity 82%, sensitivity 33%). Patients were divided into groups A (time in remission ≤7.1 years) and B ( >7.1 years). Patients in group A had significantly less mucocutaneous involvement; there were no significant differences regarding the other demographic, clinical, immunological and therapeutic variables at baseline (Table 1). Outcomes are shown in Table 2. Group B received significantly less glucocorticoids than group A and accrued significantly less damage. Osteoporosis was significantly less frequent in these patients. The prevalence of atherosclerotic vascular events and osteonecrosis was also less although insignificantly.

Conclusion: Among inception patients with SLE, clinical remission of at least 7.1 years is associated with significantly less damage over 10 years than shorter remission. While the difference in AVEs was not statistically significant, this comorbidity usually manifests later in disease course.


Disclosures: K. Tselios, None; D. Gladman, AbbVie, 2, 5, Amgen, 2, 5, Eli Lilly, 2, 5, Galapagos, 2, 5, Gilead, 2, 5, Janssen, 2, 5, Novartis, 2, 5, Pfizer, 2, 5, UCB, 2, 5, Celgene, 2, 5, Bristol Myers Squibb, 2, 5; J. Su, None; M. Urowitz, GlaxoSmithKline, 2, 5, 6, UCB, 2, Lilly, 6, AstraZeneca, 2.

To cite this abstract in AMA style:

Tselios K, Gladman D, Su J, Urowitz M. Effect of Time in Clinical Remission on Damage Accrual in Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/effect-of-time-in-clinical-remission-on-damage-accrual-in-systemic-lupus-erythematosus/. Accessed January 27, 2023.
  • Tweet
  • Email
  • Print

« Back to ACR Convergence 2021

ACR Meeting Abstracts - https://acrabstracts.org/abstract/effect-of-time-in-clinical-remission-on-damage-accrual-in-systemic-lupus-erythematosus/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences