Risk factors for damage identified in patients with SLE
medwireNews: Researchers have identified factors associated with the development of damage among patients with newly diagnosed systemic lupus erythematosus (SLE).
The study included 230 patients from the Italian multicenter Early Lupus Project with a disease duration of up to 1 year at baseline, of whom 22.2%, 25.6%, and 29.1% developed damage (SLICC/ACR Damage Index score ≥1 point) after 1, 2, and 3 years, respectively.
In a multivariate analysis, Matteo Piga (Università di Cagliari, Monserrato, Italy) and co-investigators found that older age at diagnosis, the presence of dyslipidemia, a greater number of BILAG-2004 domains, and cardiorespiratory involvement were all significantly associated with an elevated risk for the development of damage.
These risk factors differed depending on whether patients had glucocorticoid-related or -unrelated damage; cumulative prednisone equivalent dose and neuropsychiatric BILAG-2004 domain were independently associated with glucocorticoid-related damage, while dyslipidemia and cardiorespiratory involvement were associated with glucocorticoid-unrelated damage. Hydroxychloroquine use was associated with a significant reduction in the risk for glucocorticoid-unrelated damage.
Together, these findings suggest that “[a]n integrated approach addressing comorbidities, adding [hydroxychloroquine] and minimizing [glucocorticoid] use from the early stages of the disease, with the goal of remission or low disease activity, may help reduce damage,” the team concludes in Rheumatology.
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