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255 Predictors of remission and low lupus disease activity status (lldas): data from a multi-ethnic, multinational latin american lupus cohort
  1. M Ugarte-Gil1,2,
  2. D Wojdyla3,
  3. G Pons-Estel4,
  4. J Gomez-Puerta5,
  5. L Catoggio6,
  6. A Alvarellos7,
  7. V Saurit7,
  8. E Borba8,
  9. E Sato9,
  10. L Costallata10,
  11. N Da Silva11,
  12. A Iglesias-Gamarra12,
  13. O Neira13,
  14. G Reyes-Llerena14,
  15. M Cardiel15,
  16. MC Amigo1,
  17. E Acevedo-Vasquez16,
  18. M Esteva-Spinetti17,
  19. G Alarcón18 and
  20. B Pons-Estel19
  1. 1Hospital Guillermo Almenara Irigoyen. EsSalud, Rheumatology, Lima, Peru
  2. 2Universidad Científica del Sur, School of Medicine, Lima, Peru
  3. 3GLADEL, Consultant, Rosario, Argentina
  4. 4Hospital Clinic, Department of Autoimmune Diseases, Barcelona, Spain
  5. 5Universidad de Antioquia, Facultad de Medicina-, Antioquia, Colombia
  6. 6Hospital Italiano, Sección de Reumatología, Buenos Aires, Argentina
  7. 7Hospital Privado, Servicio de Reumatología, Cordoba, Argentina
  8. 8Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rheumatology, São Paulo, Brazil
  9. 9Universidade Federal de São Paulo, Departamento de Medicina, São Paulo, Brazil
  10. 10Universidade Estadual da Campinas, Divisao de Reumatologia- Faculdade de Ciencias Medicas, Campinas, Brazil
  11. 11Universidade Federal de Goiás, Faculdade de Medicina, Goiânia, Brazil
  12. 12Universidad Nacional de Colombia, Facultad de Medicina, Bogotá, Colombia
  13. 13Universidad de Chile, Facultad de Medicina, Santiago, Chile
  14. 14Centro de Investigaciones Médico Quirúrgicas -CIMEQ-, Reumatología, Habana, Cuba
  15. 15Centro de Investigación Clínica de Morelia, Reumatología, Morelia, Mexico
  16. 16Centro Medico ABC, Reumatología, México, Mexico
  17. 17Hospital Central de San Cristóbal, Reumatología, San Cristóbal, Venezuela
  18. 18The University of Alabama at Birmingham, Department of Medicine, Birmingham, USA
  19. 19Hospital Provincial de Rosario, Reumatologia, Rosario, Argentina

Abstract

Background and aims Remission and LLDAS prevent the occurrence of damage accrual in SLE patients. The aim of this study was to evaluate the predictors of remission and LLDAS in SLE patients.

Methods Three disease activity statuses were defined: Remission= SLEDAI=0 and a prednisone dose ≤5 mg/d and/or immunosuppressive drugs in maintenance dose; LLDAS=SLEDAI≤4, a prednisone dose ≤7.5 mg/d and/or immunosuppressive drugs in maintenance dose; and non-optimally controlled status= SLEDAI >4 and/or prednisone dose >7.5 mg/d and/or IS drugs in induction dose. Antimalarials were allowed in all groups. Patients with at least two SLEDAI reported and not optimally controlled at cohort entry were included in this analysis. Predefined outcomes were remission and remission/LLDAS. Potential predictors were gender, age at diagnosis, ethnicity, socioeconomic status, residence, health insurance, disease duration at cohort entry, organs/systems affected at or before cohort entry, treatment at or before cohort entry and SLEDAI at cohort entry. Univariable and multivariable Cox regression models with a stepwise selection procedure were performed for remission alone and for remission/LLDAS.

Results One-thousand one-hundred and forty patients were non-optimally controlled at cohort entry. One hundred and ninety-six patients achieved remission (17.2%) and 314 achieved remission/LLDAS (27.5%). Predictors of remission and remission/LLDAS in the multivariable models are depicted in Tables 1 and 2.

Abstract 255 Table 1

Predictors of remission. Multivariable model.

Abstract 255 Table 2

Predictors of remission/LLDAS. Multivariable model.

Conclusions Mucocutaneous manifestations, renal involvement and higher disease activity early in the course of SLE were associated with a reduced risk of remission and remission/LLDAS; lower socioeconomic status was associated with a reduced risk of remission. A medium prednisone dose was associate with an increased risk of remission/LLDAS.

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