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.
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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