Background and aims Systemic lupus erythematosus (SLE) is characterised by relapses and remissions. This study describes the frequency, type and time to flare in a cohort of SLE patients.
Methods SLE patients with one or more “A” or “B” BILAG2004 systems meeting flare criteria (items that were “new” or “worse”) and requiring an increase in immunosuppressive therapy were recruited from nine UK centres and assessed at baseline and monthly for nine months. Flares were defined as: severe (“A” flare/s irrespective of number of “B” flares), moderate (2 or more “B” flares without any “A” flares and mild (one “B” flare).
Results Of the 100 patients, 94% were female, 61% white Caucasians, mean age (SD) was 40.7 years (12.7) and mean disease duration (SD) 9.3 years (8.1). A total of 195 flares occurred in 76 patients over 781 monthly assessments, giving a flare rate of 0.25/month. There were 37 severe flares (22 patients), 32 moderate flares (19 patients) and 126 mild flares (67 patients) [Table 1]. The median time to any “A” or “B” flare was 4 months (95% CI 2.7 to 5.3 months). Figure 1 shows the time to the first mild/moderate/severe flare (Curve 1), moderate/severe flare (Curve 2) and severe flare (Curve 3). Table 2 shows that severe and moderate flares tend to be in the system/s affected at baseline whereas mild flares are more likely to affect any system.
Conclusions This real world cohort will share similarities with populations recruited to clinical studies so these results may inform future trial design.
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