Background Specific organ involvements have been proposed to be closely associated with further organ damage and deaths. However, no study ever demonstrated the rate of new organ involvement development, especially in China. This study aimed to study the characteristics of new organ involvements based on CSTAR (Chinese SLE Treatment and Research group) registry cohort.
Methods Patients were enrolled from April 2009 to February 2010, and were followed up regularly at clinic. Baseline data were collected at entry, including demography, clinical manifestations, activity (SLEDAI-2K), organ involvements, organ damages (SLLIC/Damage Index). The type and appearing time of new developed organ involvements, and new organ damages were recorded. Logistic regression model was adopted to study relationship between new organ involvements with new damage and deaths.
Results A total of 687 patients were finally included for analysis. The proportion of accumulated organ involvements in patients without relevant organ involvements were 8.91% for lupus nephritis (LN), 2.25% for hematologic involvement (HEMA), 3.13% for neuropsychiatric involvements (NEURO), 1.38% for interstitial lung disease (ILD) and 0.59% for pulmonary arterial hypertension (PAH). Logistic regression analysis showed that new developed LN [OR 3.233. p=0.004], NEURO [OR 5.314, p<0.001] and ILD [OR 12.739. p<0.001] were associated with more damage accrual and new developed PAH [OR 26.078. p=0.001] was associated with more deaths.
Conclusions Lupus nephritis, hematologic involvement and neuropsychiatric lupus were the most frequently developed new organ involvements for Chinese SLE patients. Along with interstitial lung disease and pulmonary arterial hypertension, they were closely related to damage accumulation and mortality. Therefore, we should keep an eye on them during follow-up and seek for potential strategies to prevent for new organ involvement development.
Funding Source(s): Chinese National Key Research R and D Program (2017YFC0907601, 2017YFC0907602, 2017YFC0907603), the Chinese National High Technology Research and Development Program, Ministry of Science and Technology (2012AA02A513) and the Chinese National Key Technology R and D Program, Ministry of Science and Technology (2008BAI59B02).