Poor prognosis factors in SLE: results of 5-year follow-up


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Abstract

Aim. To determine factors of poor prognosis of systemic lupus erythematosus (SLE).
Material and methods. Clinical and device examinations were made in 64 patients hospitalized with verified SLE. Its activity was assessed by SLAM and SLEDAI indices, severity - with SLICC/ACR. Five years after the primary examination the patients were re-examined. Prognostic factors were investigated using multiple linear regression and binary logistic regression.
Results. A 5-year survival of SLE patients was 87.5%. For 5 years SLICC/ACR has risen from 1.24 ± 1.29 to 2.58 ± 1.89 points (p < 0.001). Reproductive, nervous, cardiovascular and osseomuscular disorders made the greatest contribution to this rise. The age of SLE onset, SLICC/ACR at the start of the study, the absence of a rapid response to treatment were significant predictors of SLICC/ACR rise in the model of linear regression. This model explains 62.7% of the dependent index variance. The model of binary logistic regression, in which a dependent variable was survival, identified the same three indices as statistically significant. The model explained 74.4% of 5-year survival variance and predicted an outcome correctly in 86.2% cases.
Conclusion. Key factors of a poor SLE prognosis are a late SLE onset, a severe initial lesion and no rapid response to therapy.

References

  1. Cervera R., Khamashta M. A., Font J. et al. Morbidity and mortality in systemic lupus erythematosus during a 10-year period. A comparison of early and late manifestations in a cohort of 1,000 patients. Medicine (Baltimore) 2003; 82 (5): 299-308.
  2. Uramoto K. M., Michet C. J., Thumboo J. et al. Trends in the incidence and mortality of systemic lupus erythematosus, 1950-1992. Arthr. and Rheum. 1999; 42 (1): 46-50.
  3. Pons-Estel B. A., Catoggio L. J., Cardiel M. H. et al. The GLADEL multinational latin american prospective inception cohort of 1,214 patients with systemic lupus erythematosus. Medicine (Baltimore) 2004; 83 (1): 1-17.
  4. Boddaert J., Huong D. L. T., Amoura Z. et al. Late-onset systemic lupus erythematosus. A personal series of 47 patients and pooled analysis of 714 cases in the literature. Medicine (Baltimore) 2003; 82 (6): 348-359.
  5. Karlson E. W., Daltroy L. H., Lew R. A. et al. The relationship of socioeconomic status, race, and modifiable risk factors to outcomes in patients with systemic lupus erythematosus. Arthr. and Rheum. 1997; 40 (1): 47-56.
  6. Ward M. M., Pyun E., Studenski S. Long-term survival in systemic lupus erythematosus. Patient characteristics associated with poorer outcomes. Arthr. and Rheum. 1995; 38 (2): 274-284.
  7. Alarcon G. S., McGwin G. J., Petri M. et al. Baseline characteristics of a multiethnic lupus cohort: PROFILE. Lupus 2002; 11: 95-101.
  8. Tan E. M., Cohen A. S., Fries J. F. et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthr. and Rheum. 1982; 25 (11): 1271-1277.
  9. Liang M. H., Socher S. A., Larson M. G., Schur P. H. Reliability and validity of six systems for the clinical assessment of disease activity in systemic lupus erythematosus. Arthr. and Rheum. 1989; 32: 1107-1118.
  10. Gladman D., Ginzler E., Goldsmith C. et al. The development and initial validation of the SLICC/ACR Damage Index for systemic lupus erythematosus. Arthr. and Rheum. 1996; 39 (3): 363-369.
  11. Тарасова И. А., Иванова М. М. Исходы и прогноз при системной красной волчанке. Науч.-практ. ревматол. 2003; 2: 53-58.
  12. Houssiau F. A., Vasconcelos С., D'Cruz D. et al. Early response to immunosuppressive therapy predicts good renal outcome in lupus nephritis: lessons from long-term followup of patients in the Euro-Lupus Nephritis Trial. Arthr. and Rheum. 2004; 50 (12): 3934-3940.

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