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Abstract Number: 745

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 ZHAO2, Yanhong Wang3, Mengtao Li4 and Xiaofeng Zeng5, 1Peking Union Medical College Hospital, China, Beijing, China, 2Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, China, 3Department of Epidemiology and Bio-statistics (YW), Academy of Medical Sciences & Peking Union Medical College, Beijing, China, 4Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China, 5Rheumatology, Peking Union Medical College and Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Infection, remission and systemic lupus erythematosus (SLE)

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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


Disclosure: Z. Wang, None; J. ZHAO, None; Y. Wang, None; M. Li, None; X. Zeng, None.

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 .
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