scholarly journals Lupus Low Disease Activity State Associated with Lower Fatigue

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Ryan Ardian Saputro ◽  
Santi Andayani ◽  
Stefanie Yuliana Usman ◽  
Laniyati Hamijoyo
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Asia Pacific ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Low Disease Activity ◽  
Activity State

Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disease with heterogeneous clinical manifestations including fatigue. Previous studies aimed at proving the relationship between fatigue and SLE disease activity showed conflicting results. In 2015, Asia Pacific Lupus Collaboration (APLC) developed low disease activity criteria, named Lupus Low Disease Activity State (LLDAS). Patients who spend more time in LLDAS have significantly lower morbidity. This study aimed to evaluate the association between disease activity based on LLDAS and fatigue.    Methods: This is a analytical cross-sectional study. Subjects were SLE patients at rheumatology clinic in Dr. Hasan Sadikin Hospital, Bandung during June-January 2018. Subjects were evaluated based on LLDAS criteria and divided into 2 groups: LLDAS and non-LLDAS. Fatigue status of the subjects was assessed with Fatigue Severity Scale (FSS). Results: A hundred and thirty-three subjects were included in this study, divided into 63 subjects in LLDAS group and 60 subjects in non-LLDAS group. Nineteen subjects (30.2%) in LLDAS group had fatigue and 39 subjects (65%) in non-LLDAS had fatigue. There was a significant association between LLDAS and fatigue (p< 0.001). Nonetheless, fatigue level in LLDAS group was still high since disease activity was not the only factor related to fatigue. Fatigue may be a distinct clinical manifestation of neuropsychiatric lupus and may be independent of lupus disease activity Conclusions: There was a significant association between LLDAS and fatigue showed by lower fatigue level was found in the LLDAS group than in the non-LLDAS group.   Keywords: Systemic lupus erythematosus, disease activity, Lupus Low Disease Activity State, fatigue

scholarly journals AB0376 DETERMINANTS AND PROTECTIVE EFFECTS OF A LOW DISEASE ACTIVITY STATE IN SYSTEMIC LUPUS ERYTHEMATOSUS: RESULTS FROM A PROSPECTIVE CHINESE COHORT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1488-1489
Author(s):  
Y. Hao ◽  
L. Ji ◽  
D. Gao ◽  
Y. Fan ◽  
E. F. Morand ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Asia Pacific ◽  
Systemic Lupus ◽  
Low Disease Activity ◽  
Disease Flare ◽  
Damage Accrual ◽  
Activity State

Background:The concept of treat to target in systemic lupus erythematosus has moved forward in recent years. The Lupus low disease activity state (LLDAS) defined by the Asia-Pacific Lupus Collaboration (APLC) in 2016 has been validated prospectively in the APLC cohort itself and retrospectively in multiple other cohorts.Objectives:The concept of treat to target in systemic lupus erythematosus has moved forward in recent years. The Lupus low disease activity state (LLDAS) defined by the Asia-Pacific Lupus Collaboration (APLC) in 2016 has been validated prospectively in the APLC cohort itself and retrospectively in multiple other cohorts. The aim of this study was to investigate the frequency and determinants of achieving LLDAS, and the influence of LLDAS on short term outcomes including disease flare and damage accrual in Chinese lupus patients.Methods:The baseline and follow-up data of all consecutive patients in a longitudinal lupus cohort from January 2017 to December 2018 were collected prospectively. SLEDAI-2K, PGA and disease flare were assessed at each follow-up visit, and further compared to the previous routine clinical visits. Irreversible disease damage was captured using the SLICC damage index and the short form (36) health survey for health-related quality of life was completed annually.Results:One hundred and forty-nine patients were enrolled, with the median disease duration at recruitment of 2.4 (0.9–8.2) years, and median follow-up of 15.4 (10.1-18.2) months. By the end of the study, 104 (69.8%) patients achieved LLDAS at least once; 59 patients achieved LLDAS for≥50% of observations. Multivariate logistic regression analysis showed that age at disease onset< 30 years (OR=0.05, 95%CI [0.01-0.59], p=0.017), 24-hour urine total protein (UTP) level at recruitment (OR=0.9992, 95%CI [0.9987-0.9998], p=0.007), and C3 level (OR=1.004, 95%CI [1.001-1.008], p=0.024) had independent associations with achieving LLDAS for≥50% of all observations (Table 1). During follow-up, 56 (37.6%) patients experienced disease flare including 14 (9.4%) patients with severe flare. Kaplan-Meier analyses showed significant differences in flare rates according to whether LLDAS was achieved and the percentage follow-up time in LLDAS (Figure 1). Multivariate cox analysis revealed that the percentage time of time in LLDAS was an independent negative determinant of disease flare (HR=0.18, 95% CI [0.07-0.48], p=0.001) (Table 2). There were 16 (15.0%)/107 patients who had damage accrual after one year of follow-up. Multivariate logistic analysis showed a tendency for achieving LLDAS during follow-up being protective for damage accrual (OR=0.27, 95%CI [0.07-1.00], p=0.050).Conclusion:In this Chinese early disease cohort, LLDAS was an attainable goal in clinical practice. Age at onset, UTP and C3 level at recruitment influenced achievement of LLDAS. LLDAS was negatively associated with disease flare and damage accrual; this needs to be confirmed by future longer follow-up.Acknowledgments:The data in this cohort was collected and recorded using the framework of the lupus low disease activity status (LLDAS) study from the Asia-Pacific Lupus Collaboration (APLC).Disclosure of Interests:Yanjie Hao: None declared, Lanlan Ji: None declared, Dai Gao: None declared, Yong Fan: None declared, Eric F. Morand Grant/research support from: AstraZeneca, Consultant of: AstraZeneca, Speakers bureau: AstraZeneca, Mandana Nikpour: None declared, Zhuoli Zhang: None declared

scholarly journals Therapeutic adherence in patients with systemic lupus erythematosus: a cross-sectional study

2018 ◽  
Vol 56 (2) ◽  
pp. 109-115 ◽  
Author(s):  
Lucia Mazur-Nicorici ◽  
Victoria Sadovici-Bobeica ◽  
Maria Garabajiu ◽  
Minodora Mazur
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Adherence To Treatment ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Low Disease Activity ◽  
High Adherence

Abstract Introduction. The aim of the research was the study of the adherence to treatment in patients with systemic lupus erythematosus. Methods. Cross-sectional study including 132 consecutive patients with systemic lupus erythematosus (SLICC, 2012 classification criteria). We collected clinical and socio-demographic data, socio-economic status; we assessed SLEDAI-2k disease activity, and estimated the adherence to treatment by Morisky questionnaire. Results. Our results demonstrated that low adherence to treatment in patients with systemic lupus erythematosus was in only 11.36% of patients, while 43.18% and 45.46% of the patients were scored as moderate and high adherence, respectively. A moderate/high adherence to treatment was associated to a high level of education (r = −0.51, p < 0.05, 95% CI = −0.25 to −0.66), low disease activity (r = 0.38, p < 0.05, 95% CI = 0.25 to 0.53) and low indices of physician global assessment (r = −0.31, p<0.05, 95% CI = −0.23 to −0.71). The sub-analysis of the adherence to each drug demonstrated that the highest adherence was to treatment with glucocorticosteroids – 92.85%, followed by hydroxychloroquine and aspirin – 92.15% and 89.79%, respectively. Conclusion. In our cohort, the adherence to treatment was high in 45.46%, moderate in 43.18% and low in only 11.36% cases. High adherence to treatment was associated to low disease activity. The adherence was positively influenced by the age at the onset of the disease and a high educational level.

scholarly journals Correlation Between Cognitive Function with Disease Activity of Systemic Lupus Erythematosus Patients in Dr. Hasan Sadikin Hospital Bandung: An Analytical Cross-Sectional Study

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Aep Saepudin ◽  
Paulus Anam Ong ◽  
Syarief Hidayat ◽  
Andri Reza Rahmadi ◽  
Laniyati Hamijoyo
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cognitive Function ◽  
Disease Activity ◽  
Cognitive Dysfunction ◽  
Lupus Erythematosus ◽  
Cross Sectional Study ◽  
Median Score ◽  
Sectional Study ◽  
Systemic Lupus ◽  
Cross Sectional

Background: Cognitive dysfunction was found in 55-80% Neuropsychiatry Systemic Lupus Erythematosus (NPSLE) patients. Serious concern from clinicans was needed as its impact to patient’s quality of life. Disease activity is expected to be affecting patient’s cognitive function. Previous studies regarding correlation between disease activity and cognitive dysfunction showed various results. This study aimed to evaluate the correlation between disease activity and cognitive function in SLE patients.Methods: This study is an analytical cross-sectional study. Subjects were SLE patients at the rheumatology clinic of Dr. Hasan Sadikin Hospital Bandung during June-August 2017. Subject’s evaluations included disease activity assessment using SLE disease activity index-2K (SLEDAI-2K) and cognitive function assessment using MoCA-Ina test. Data were analyzed by using Spearman Rank correlation test. Results: Mean age of the subjects was 31 ± 8 years old, most of them were senior high school graduates (65.8 %) and median length of study was 12 years. Subject’s median duration of illness was 44 months. Their MoCA-Ina median score was 25, while SLEDAI-2K median score was 6. Cognitive dysfunctions were found in more than half of subjects (52.63%), which memory domain (78.95%) was most frequently impaired. Most of subjects were patients with active SLE (63.2%). Correlation test showed there was no correlation between SLEDAI-2K score and MoCA-Ina score (rs=0.023, p=0.445).Conclusion: There was no correlation between disease activity (SLEDAI-2K score) and cognitive function (MoCA-Ina score). Keywords: Cognitive dysfunction, MoCA-Ina, Systemic lupus erythematosus, SLEDAI-2K

scholarly journals Time in remission and low disease activity state (LDAS) are associated with a better quality of life in patients with systemic lupus erythematosus: results from LUMINA (LXXIX), a multiethnic, multicentre US cohort

RMD Open ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e000955 ◽  
Author(s):  
Manuel Francisco Ugarte-Gil ◽  
Guillermo J Pons-Estel ◽  
Luis M Vila ◽  
Gerald McGwin ◽  
Graciela S Alarcón
Keyword(s):  
Quality Of Life ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Short Form ◽  
Systemic Lupus ◽  
Low Disease Activity ◽  
Sf 36 ◽  
Activity State

AimsTo determine whether the proportion of time systemic lupus erythematosus patients achieve remission/low disease activity state (LDAS) is associated with a better quality of life (QoL).Patients and methodsPatients from a well-established multiethnic, multicentre US cohort were included: remission: Systemic Lupus Activity Measure (SLAM) score=0, prednisone≤5 mg/day and no immunosuppressants); LDAS not in remission, SLAM score≤3, prednisone≤7.5 mg/day, no immunosuppressants; the combined proportion of time patients were in these states was the independent variable. The endpoints were the Physical and Mental Components Summary measures (PCS and MCS, respectively) and the individual subscales of the Short Form (SF)-36 at the last visit. Linear regression was used to estimate the association between the proportion of follow-up time in remission/LDAS and the SF-36 measures with and without adjustment for possible confounders.ResultsFour hundred and eighty-three patients were included. The per cent of time on remission/LDAS was associated with better QoL after adjusting for potential confounders; for the PCS the parameter estimate was 9.47 (p<0.0001), for the MCS 5.89 (p=0.0027), and for the subscales they ranged between 7.51 (p=0.0495) for mental health and 31.79 (p<0.0001) for role physical.ConclusionsThe per cent of time lupus patients stay on remission/LDAS is associated with a better QoL as measured by SF-36.

Predictors of Remission and Low Disease Activity State in Systemic Lupus Erythematosus: Data from a Multiethnic, Multinational Latin American Cohort

2019 ◽  
Vol 46 (10) ◽  
pp. 1299-1308 ◽  
Author(s):  
Manuel F. Ugarte-Gil ◽  
Daniel Wojdyla ◽  
Guillermo J. Pons-Estel ◽  
Rosana Quintana ◽  
José A. Gómez-Puerta ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Maintenance Dose ◽  
Renal Involvement ◽  
Immunosuppressive Drugs ◽  
Older Age ◽  
Systemic Lupus ◽  
Low Disease Activity ◽  
Activity State

Objective.To determine the predictors of remission and low disease activity state (LDAS) in patients with systemic lupus erythematosus (SLE).Methods.Three disease activity states were defined: Remission = SLE Disease Activity Index (SLEDAI) = 0 and prednisone ≤ 5 mg/day and/or immunosuppressants (maintenance dose); LDAS = SLEDAI ≤ 4, prednisone ≤ 7.5 mg/day and/or immunosuppressants (maintenance dose); and non-optimally controlled state = SLEDAI > 4 and/or prednisone > 7.5 mg/day and/or immunosuppressants (induction dose). Antimalarials were allowed in all groups. Patients with at least 2 SLEDAI reported and not optimally controlled at entry were included in these analyses. Outcomes were remission and LDAS. Multivariable Cox regression models (stepwise selection procedure) were performed for remission and for LDAS.Results.Of 1480 patients, 902 were non-optimally controlled at entry; among them, 196 patients achieved remission (21.7%) and 314 achieved LDAS (34.8%). Variables predictive of a higher probability of remission were the absence of mucocutaneous manifestations (HR 1.571, 95% CI 1.064–2.320), absence of renal involvement (HR 1.487, 95% CI 1.067–2.073), and absence of hematologic involvement (HR 1.354, 95% CI 1.005–1.825); the use of immunosuppressive drugs before the baseline visit (HR 1.468, 95% CI 1.025–2.105); and a lower SLEDAI score at entry (HR 1.028, 95% CI 1.006–1.051 per 1-unit decrease). These variables were predictive of LDAS: older age at entry, per 5-year increase (HR 1.050, 95% CI 1.004–1.098); absence of mucocutaneous manifestations (HR 1.401, 95% CI 1.016–1.930) and renal involvement (HR 1.344, 95% CI 1.049–1.721); and lower SLEDAI score at entry (HR 1.025, 95% CI 1.009–1.042).Conclusion.Absence of mucocutaneous, renal, and hematologic involvement, use of immunosuppressive drugs, and lower disease activity early in the course of the disease were predictive of remission in patients with SLE; older age was predictive of LDAS.

Sign in / Sign up

Export Citation Format

Share Document