Arthritis care & research · 2026
Discordance Between Systemic Lupus Erythematosus Disease Activity Index Domain Weights and Their Association With Organ Damage Accrual.
СтатьяНазвание и аннотация: Перевод в очереди
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Zhang Kevin, Morand Eric F, Boyd Sarah E, Petitjean François, Hoi Alberta, Koelmeyer Rachel, Miceli Iolanda, Monk Julie A, Nim Hieu T
Аннотация
OBJECTIVE: Studies of damage accrual in patients with systemic lupus erythematosus (SLE) show associations with disease activity measured by the SLE Disease Activity Index 2000 (SLEDAI-2K), but these associations are imperfect. SLEDAI scores are powerfully influenced by weightings (1-8) assigned to each domain. We investigated whether the weightings of SLEDAI-2K domain scores aligned with the risk of organ damage accrual.
METHODS: In patients with SLE attending a single center from 2007 to 2016, disease activity (SLEDAI-2K) and organ damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index; SDI) were recorded prospectively at each visit and annually, respectively. Visits were dichotomized according to whether the visit occurred during a period of damage transition (increase in SDI in the same year). Associations were assessed using Fisher exact test (univariable analysis) and generalized linear mixed-effect models (multivariable analysis).
RESULTS: We analyzed 5,538 visits of 266 patients (86.5% female, 51.5% White). SLEDAI-2K domains positively associated with damage transition all had weights of ≤4 (odds ratio [95% confidence interval]: pericarditis, 5.39 [1.59-18.3] P < 0.01; pleurisy, 2.12 [1.14-3.94] P = 0.02; arthritis, 1.40 [1.02-1.94] P = 0.04; and leukopenia, 1.52 [1.04-2.24] P = 0.03). Higher-weighted SLEDAI-2K domains were negatively associated with damage transition, not associated, or were too infrequent to assess.
CONCLUSION: Associations of SLEDAI-2K domains with damage accrual were variable and were discordant with domain weightings. Alternative weighting strategies for disease activity instruments could improve their prognostic utility.
METHODS: In patients with SLE attending a single center from 2007 to 2016, disease activity (SLEDAI-2K) and organ damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index; SDI) were recorded prospectively at each visit and annually, respectively. Visits were dichotomized according to whether the visit occurred during a period of damage transition (increase in SDI in the same year). Associations were assessed using Fisher exact test (univariable analysis) and generalized linear mixed-effect models (multivariable analysis).
RESULTS: We analyzed 5,538 visits of 266 patients (86.5% female, 51.5% White). SLEDAI-2K domains positively associated with damage transition all had weights of ≤4 (odds ratio [95% confidence interval]: pericarditis, 5.39 [1.59-18.3] P < 0.01; pleurisy, 2.12 [1.14-3.94] P = 0.02; arthritis, 1.40 [1.02-1.94] P = 0.04; and leukopenia, 1.52 [1.04-2.24] P = 0.03). Higher-weighted SLEDAI-2K domains were negatively associated with damage transition, not associated, or were too infrequent to assess.
CONCLUSION: Associations of SLEDAI-2K domains with damage accrual were variable and were discordant with domain weightings. Alternative weighting strategies for disease activity instruments could improve their prognostic utility.