Systemic lupus erythematosus in a multiethnic US cohort (LUMINA) XXVII:: factors predictive of a decline to low levels of disease activity

被引:12
作者
Bertoli, AM
Alarcón, GS
McGwin, G
Fernández, M
Bastian, HM
Fessler, BJ
Vilá, LM
Reveille, JD
机构
[1] Univ Alabama Birmingham, Dept Med, Div Clin Immunol & Rheumatol, Birmingham, AL 35294 USA
[2] Univ Alabama Birmingham, Sch Med, Dept Surg, Sect Trauma Burns & Crit Care, Birmingham, AL 35294 USA
[3] Univ Texas, Hlth Sci Ctr, Dept Med, Div Rheumatol, Houston, TX USA
[4] Dept Internal Med, Div Rheumatol, San Juan, PR USA
关键词
systemic lupus erythematosus; disease activity; longitudinal cohort;
D O I
10.1191/0961203306lu2256oa
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The objective of this study was to examine factors predictive of a decline to low levels of disease activity in a cohort of systemic lupus erythematosus (SLE) patients. Patients with SLE of Hispanic (from Texas or Puerto Rico), African-American or Caucasian ethnicity from a multiethnic cohort were included. A decline to low levels of disease activity was defined as a score <= 5 as per the Systemic Lupus Activity Measure-Revised (SLAM-R) at any annual study visit if preceded by a SLAM-R >= 8. Using Generalized Estimating Equation (GEE), socioeconomic-demographic, behavioral, function, psychological, laboratory and clinical data [disease manifestations, number of ACR criteria accrued at diagnosis and damage accrual as per the Systemic Lupus International Collaborating Clinics (SLICC) Damage Index (SDI)] from the visit preceding that meeting the definition were examined as predictors of decline to low levels of disease activity. Two-hundred and eighty-seven patients (67 Hispanics from Texas, 32 Hispanics form Puerto Rico, 120 African-Americans and 68 Caucasians), accounting for 632 visits were analyzed. In the GEE multivariable analysis, higher degrees of social support (OR = 1.208, 95% CI 1.059-1.379; P = 0.005) were predictive of a decline to low levels of disease activity, while the number of ACR criteria accrued at diagnosis (OR = 0.765, 95% CI 0.631-0.927; P = 0.006) and damage (OR = 0.850, 95% CI 0.743-0.972, P = 0.018) were negatively associated. These data suggest that a decline to low levels of disease activity in lupus patients seems to be multifactorial; this study also underscores the importance of social support for lupus patients.
引用
收藏
页码:13 / 18
页数:6
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