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首页> 外文期刊>Rheumatology >Identification of clinical predictors of flare in systemic lupus erythematosus patients: A 24-month prospective cohort study
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Identification of clinical predictors of flare in systemic lupus erythematosus patients: A 24-month prospective cohort study

机译：确定系统性红斑狼疮患者发作的临床预测指标：一项为期24个月的前瞻性队列研究

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Objective. SLE has a relapsing-remitting course with disease activity flares over time. This study aims to identify clinical predictors of SLE flares. Methods. This prospective cohort study over 24 months included all SLE patients on follow-up at one academic lupus clinic. Flare was defined as an increase in SLEDAI-2K score ≥4 points. Baseline clinical and demographic parameters were compared using survival analysis for time-to-flare outcome with univariate log-rank tests. Variables with significant differences were further evaluated as predictors with multivariate Cox regression models adjusting for potential confounding or contributing factors and hazard ratio (HR) calculation. Results. A total of 202 SLE patients were included. Over the follow-up period, 1083 visits were documented and 16.8% of patients presented with flares. In multivariate analysis, the following parameters emerged as flare predictors: SLE diagnosis up to 25 years of age (HR = 2.14, P = 0.03), lupus nephritis previous to baseline visit (HR = 4.78, P<0.0001) and immunosuppressor treatment for severe SLE (HR = 3.22, P<0.001). Baseline disease activity, disease duration and treatment with prednisone or HCQ were not predictive factors. Conclusion. Patients with an SLE diagnosis before age 25 years, lupus nephritis or immunosuppressor treatment for severe SLE present greater HRs for flares, suggesting the need for tighter clinical monitoring. Current immunosuppressive strategies seem to be inefficient in providing flare prevention.
机译：目的。 SLE具有复发-缓解过程，随着时间的推移，疾病活动性发作会加剧。这项研究旨在确定SLE耀斑的临床预测指标。方法。这项为期24个月的前瞻性队列研究包括了所有在一家学术性狼疮诊所接受随访的SLE患者。眩光定义为SLEDAI-2K得分增加≥4分。基线临床和人口统计学参数使用生存分析与单变量对数秩检验的发作时间比较。具有显着差异的变量将通过多变量Cox回归模型作为预测因子进行评估，该模型针对潜在的混淆或影响因素以及危险比（HR）计算进行了调整。结果。总共包括202名SLE患者。在随访期间，记录了1083次就诊，并且有16.8％的患者出现了耀斑。在多变量分析中，以下参数可作为耀斑预测指标：25岁以下的SLE诊断（HR = 2.14，P = 0.03），基线访视前的狼疮性肾炎（HR = 4.78，P <0.0001）和严重的免疫抑制剂治疗SLE（HR = 3.22，P <0.001）。基线疾病活动，疾病持续时间以及泼尼松或HCQ的治疗不是预测因素。结论。在25岁之前诊断为SLE，狼疮肾炎或严重SLE的免疫抑制剂治疗的患者，出现耀斑的HR更高，这表明需要更严格的临床监测。当前的免疫抑制策略似乎在提供耀斑预防方面效率低下。

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