scholarly journals Risk factors for the flare of systemic lupus erythematosus and its influence on prognosis: a single-center retrospective analysis

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Xiaohong Zeng ◽  
Ling Zheng ◽  
Hongbing Rui ◽  
Rihui Kang ◽  
Junmin Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Pulmonary Hypertension ◽  
Maintenance Therapy ◽  
Lupus Erythematosus ◽  
Multivariate Regression Analysis ◽  
Sustained Remission ◽  
Igg Antibodies ◽  
Systemic Lupus ◽  
Glycoprotein I

Abstract Objectives To explore the risk factors for systemic lupus erythematosus (SLE) flare and their impact on prognosis. Methods The clinical characteristics, laboratory results, and treatment plans of 121 patients with SLE flare were retrospectively analyzed. Ninety-eight SLE outpatients with sustained remission during the same period were selected as controls. Logistic multivariate regression analysis was employed to screen for risk factors for SLE flare. Results Infection, thrombocytopenia, arthritis, anti-nucleosome antibodies positive, anti-β2-glycoprotein I (IgG) antibodies positive, and patient’s self-discontinuation of medicine maintenance therapy might be risk factors for SLE flare. Patients who discontinued medicine maintenance therapy by themselves had a significantly higher rate of severe SLE flare than patients with regular medicine maintenance therapy (P = 0.033). The incidence of anemia associated with SLE (P = 0.001), serositis (P = 0.005), and pulmonary hypertension (P = 0.003) in patients who discontinued medicine maintenance therapy were significantly higher than patients with regular medicine maintenance therapy. SLE patients with regular medicine maintenance therapy for less than 3 years had a higher risk of pulmonary hypertension than those with regular medicine maintenance therapy longer than 3 years (P = 0.034). Conclusions The accompanying thrombocytopenia, arthritis, anti-nucleosome antibodies positive and anti-β2-glycoprotein I (IgG) antibodies positive at the onset of SLE may affect the prognosis of SLE. Patient’s self-discontinuation of medicine maintenance therapy is the main cause of SLE flare, which may induce severe flare in SLE patients and lead to a significantly higher incidence of pulmonary hypertension.

Validation of the adjusted global antiphospholipid syndrome score in systemic lupus erythematosus patients in Argentina

Lupus ◽  
2020 ◽  
Vol 29 (14) ◽  
pp. 1866-1872
Author(s):  
Lucila Garcia ◽  
Maria S Velloso ◽  
Maria V Martire ◽  
Florencia Savy ◽  
Fernando Arizpe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Lupus Erythematosus ◽  
Multivariate Logistic Regression Analysis ◽  
Igg Antibodies ◽  
Multivariate Logistic Regression ◽  
Systemic Lupus ◽  
Pregnancy Morbidity

Introduction Assessment of risk both for pregnancy morbidity and thrombosis in the presence of anti-phospholipid antibodies (aPL) is still a challenge in Systemic Lupus Erythematosus (SLE) patients. The Global Antiphospholipid Syndrome Score (GAPSS) takes into account the aPL profile (criteria and non-criteria aPL), the conventional cardiovascular risk factors and the autoimmune antibody profile. An adjusted model of the score (aGAPSS) excluding anti-phosphatidylserine/Prothrombin (aPS/PT), suggests that the score is able to stratify patients for their rate of events making it widely applicable in daily clinical practice. Objective To validate the aGAPSS in a multicentric cohort of SLE patients in Argentina. Patients and methods consecutive SLE patients with and with andwithout thrombotic events from seven Rheumatologist centers were included. Traditional cardiovascular risk factors, aPL antibodies and medications received (aspirin, hydroxychloroquine and anticoagulation) were collected. The score aGAPSS was calculated for each patient at the last visit by adding together the points corresponding to the risk factors: 1 for hypertension, 3 for dyslipidemia, 4 for LA and B2GPI (IgM or IgG) antibodies and 5 for aCL (IgM or IgG) antibodies. The discriminative ability of the aGAPSS was calculated by measuring the area under the receiver operating characteristic curve (AUC). Multivariate logistic regression analysis was performed to examine the impact of multiple cardiovascular risk factors and laboratory parameters on the occurrence of thrombosis. Results Two hundred and ninety-six SLE patients were included. One-hundred and twenty-one patients (40.9%) presented thrombotic and/or pregnancy complications. Median aGAPSS was significantly higher in patients who experienced an event (thrombosis and/or pregnancy morbidity) compared with those without [4 (IQR 1–9) versus 1 (IQR 0–5); p < 0.001]. The best cut off point for the diagnosis of thrombosis and/or pregnancy complications was aGAPSS ≥4. Multivariate logistic regression analysis showed that aCL antibodies [OR 2.1 (95% CI 1.16–3.90); p = 0.015] were an independent risk factors for thrombotic events. Conclusions This score is a simple tool, easy to apply to SLE patients in daily practice. The use of the aGAPSS could change the non-pharmacologic and pharmacologic treatment in higher risk patients to improve their survival.

scholarly journals Cancer risk factors in systemic lupus erythematosus: multivariate regression analysis in 16,409 patients

2014 ◽  
Vol 16 (Suppl 1) ◽  
pp. A35
Author(s):  
Sasha Bernatsky ◽  
Rosalind Ramsey-Goldman ◽  
Jean-François Boivin ◽  
Lawrence Joseph ◽  
Michelle A Petri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Regression Analysis ◽  
Cancer Risk ◽  
Lupus Erythematosus ◽  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
Systemic Lupus ◽  
Cancer Risk Factors

scholarly journals Lupus With Pregnancy : Beyond the Basics

2012 ◽  
Vol 23 (1) ◽  
pp. 53-56
Author(s):  
Sujat Paul
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Fetal Outcome ◽  
Maternal Serum ◽  
Systemic Lupus ◽  
Immunological Mechanism ◽  
Glycoprotein I ◽  
Adverse Pregnancy ◽  
Maternal Disease

Pregnancy in patients with systemic lupus erythematosus is associated with a high risk of maternal disease exacerbation and adverse fetal outcome. This review summarizes recent published findings on lupus pregnancy. Literature review: The literature has profound agreement on thefact that, for most women with inactive and stable systemic lups erythematousus, pregnancy is safe for both mother and fetus. The main risk factors for adverse pregnancy course and outcome are active disease, nephritis with proteinuria, hypertension and maternal serum antibodies to SS-A/Ro, SS-B/La, cardiolipin, 2-glycoprotein I, and lupus anticoagulant. Recent studies have broadened our understanding of the immunological mechanism underlying congenital heart block induced by anti-Ro/La antibodies. Pregnancy in patients with systemic lupus erythematosus is safe and manageable provided the disease is stable. Patients should be closely followed up before pregnancy for pregestational risk factors and should get extra attention during gregnancy. The disease can be safely managed in some cases of lupus flare during pregnancy. JCMCTA 2012; 23(1): 53-56

Risk Factors Associated with Systemic Lupus Erythematosus in Oman

2020 ◽  
Vol 03 (04) ◽  
Author(s):  
Asma Al-Kindi ◽  
Batool Hassan ◽  
Aliaa Al-Moqbali ◽  
Aliya Alansari
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Factors Associated

Rituximab induces a rapid and sustained remission in Colombian patients with severe and refractory systemic lupus erythematosus

Lupus ◽  
2011 ◽  
Vol 20 (11) ◽  
pp. 1219-1226 ◽  
Author(s):  
LF Pinto ◽  
CJ Velásquez ◽  
C Prieto ◽  
L Mestra ◽  
E Forero ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Sustained Remission ◽  
Systemic Lupus

scholarly journals Predictors of renal damage in systemic lupus erythematous patients: data from a multiethnic, multinational Latin American lupus cohort (GLADEL)

RMD Open ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e001299
Author(s):  
Cristina Reátegui-Sokolova ◽  
Manuel F Ugarte-Gil ◽  
Guillermina B Harvey ◽  
Daniel Wojdyla ◽  
Guillermo J Pons-Estel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Latin American ◽  
Lupus Erythematosus ◽  
Renal Damage ◽  
Cox Regression ◽  
Damage Index ◽  
Early Response ◽  
Male Gender ◽  
Systemic Lupus

AimA decrease in proteinuria has been considered protective from renal damage in lupus nephritis (LN), but a cut-off point has yet to be established. The aim of this study was to identify the predictors of renal damage in patients with LN and to determine the best cut-off point for a decrease in proteinuria.MethodsWe included patients with LN defined clinically or histologically. Possible predictors of renal damage at the time of LN diagnosis were examined: proteinuria, low complement, anti-double-stranded DNA antibodies, red cell casts, creatinine level, hypertension, renal activity (assessed by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)), prednisone dose, immunosuppressive drugs and antimalarial use. Sociodemographic variables were included at baseline. Proteinuria was assessed at baseline and at 12 months, to determine if early response (proteinuria <0.8 g/day within 12 months since LN diagnosis) is protective of renal damage occurrence. Renal damage was defined as an increase of one or more points in the renal domain of The Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI). Cox regression models using a backward selection method were performed.ResultsFive hundred and two patients with systemic lupus erythematosus patients were included; 120 patients (23.9%) accrued renal damage during their follow-up. Early response to treatment (HR=0.58), antimalarial use (HR=0.54) and a high SES (HR=0.25) were protective of renal damage occurrence, whereas male gender (HR=1.83), hypertension (HR=1.86) and the renal component of the SLEDAI (HR=2.02) were risk factors for its occurrence.ConclusionsEarly response, antimalarial use and high SES were protective of renal damage, while male gender, hypertension and higher renal activity were risk factors for its occurrence in patients with LN.

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