Longitudinal comparison of treat-to-target states and clinical outcomes in patients with late-onset versus early-onset systemic lupus erythematosus.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Louthrenoo Worawit, Hoi Alberta, Golder Vera, Chen Yi-Hsing, Cho Jiacai, Lateef Aisha, Hamijoyo Laniyati, Wu Yeong-Jian Jan, Navarra Sandra V, Zamora Leonid, Li Zhanguo, Sockalingam Sargunan, Katsumata Yasuhiro, Hao Yanjie, Zhang Zhuoli, Basnayake B M D B, Chan Madelynn, Kikuchi Jun, Kaneko Yuko, Takeuchi Tsutomu, Oon Shereen, Bae Sang-Cheol, Ng Kristine Pek Ling, O'Neill Sean, Hassett Geraldine, Goldblatt Fiona, Tan Tze-Chin, Tugnet Nicola, Tee Cherica, Tee Michael, Sapsford Mark, Chan Chiu Wai Shirley, Lau Chak Sing, Ohkubo Naoaki, Miyazaki Yusuke, Tanaka Yoshiya, Nikpour Mandana, Morand Eric F, Kandane-Rathnayake Rangi
Аннотация
METHODS: We analyzed prospectively collected data from patients enrolled in the Asia Pacific Lupus Collaboration cohort. Patients diagnosed with SLE at age >50 years were classified as LO-SLE and compared with those diagnosed at age ≤50 years (EO-SLE). Longitudinal associations with treatment targets (LLDAS and DORIS remission), organ damage accrual (SLICC/ACR Damage Index), and HRQoL (SF36v2 physical and mental component summary (PCS and MCS) scores) were examined using multivariable multilevel logistic, recurrent-event survival, and linear mixed-effects models, respectively. Disease activity, flares, medication exposure, and other clinical characteristics were also compared between groups.
RESULTS: Among 3,917 patients studied, 346 (8.8%) had LO-SLE. Compared with EO-SLE, patients with LO-SLE had lower disease activity, lower glucocorticoid and immunosuppressant exposure, and higher attainment of treatment targets; LO-SLE was associated with higher odds of attaining LLDAS (OR: 2.33 (1.66, 3.28)) and DORIS remission (OR: 2.22 (1.45, 3.38)). However, they were at a greater risk of damage accrual (HR:1.82 (1.50, 2.21)) and lower PCS scores, meaning poorer physical health (regression coefficient (RC) = -3.63 (-4.58, -2.68)) but not MCS (RC= 0.68 (-.50, 1.86)).
CONCLUSION: Despite higher attainment of treatment targets, patients with LO-SLE experienced greater damage accrual and poorer physical health, suggesting that disease activity targets alone may not fully capture outcome risk in LO-SLE.