Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Av. Grau 800, La Victoria, Lima 13, Lima, Peru.
Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Av. Grau 800, La Victoria, Lima 13, Lima, Peru; Universidad Científica del Sur, Lima, Peru.
Semin Arthritis Rheum. 2017 Oct;47(2):199-203. doi: 10.1016/j.semarthrit.2017.01.012. Epub 2017 Feb 2.
To determine the factors predictive of disease activity early in the course of SLE (baseline visit).
Patients from GLADEL, a multi-national, multi-ethnic, Latin-American lupus cohort were included. Disease activity was evaluated at baseline with the SLEDAI score. Demographic characteristics (age at diagnosis, gender, ethnicity, marital status, educational level, medical coverage and socioeconomic status) were assessed. Disease duration was defined as the time between the fourth ACR criterion and baseline. Time to criteria accrual was defined as the interval between the first and fourth ACR criterion. Use of glucocorticoids was recorded as the highest dose received before the baseline visit. Antimalarials and immunosuppressive drugs were recorded as use or not use. Univariable and multivariable analysis were performed. Model selection was based on backward elimination.
One thousand two hundred sixty-eight patients were included; 1136 (89.6%) of them were female. Mean age at diagnosis was 29.2 (SD: 12.3) years. Five hundred sixty-five (44.6%) were Mestizo, 539 (42.5%) were Caucasians and 164 (12.9%) were African-Latin-Americans. The mean SLEDAI at baseline was 10.9 (SD: 8.4). Longer time between first and fourth ACR criterion, medical coverage, a dose of prednisone between 15 and 60mg/d, and the use of antimalarials were factors protective of disease activity, while Mestizo and African-Latin-American ethnicities were predictive factors.
Mestizo and African-Latin-American ethnicities were predictive whereas antimalarial use, medical coverage, and longer time to criteria accrual were protective of higher disease activity early in the disease course.
确定在系统性红斑狼疮（SLE）病程早期（基线访视）疾病活动的预测因素。
本研究纳入了来自 GLADEL 的患者，这是一个多国家、多民族、拉丁美洲狼疮队列。基线时使用 SLEDAI 评分评估疾病活动。评估人口统计学特征（诊断时的年龄、性别、种族、婚姻状况、教育水平、医疗保障和社会经济地位）。疾病持续时间定义为从第四个 ACR 标准到基线的时间。达到标准的时间定义为从第一个 ACR 标准到第四个 ACR 标准的间隔。记录在基线访视前接受的最高剂量的糖皮质激素。记录是否使用抗疟药和免疫抑制剂。进行单变量和多变量分析。模型选择基于向后消除法。
共纳入 1268 例患者；其中 1136 例（89.6%）为女性。诊断时的平均年龄为 29.2（SD：12.3）岁。565 例（44.6%）为梅斯蒂索人，539 例（42.5%）为白种人，164 例（12.9%）为非洲裔拉丁裔美国人。基线时 SLEDAI 的平均得分为 10.9（SD：8.4）。从第一个 ACR 标准到第四个 ACR 标准的时间间隔较长、医疗保障、泼尼松剂量为 15-60mg/d 以及使用抗疟药是疾病活动的保护因素，而梅斯蒂索人和非洲裔拉丁裔美国人则是预测因素。
梅斯蒂索人和非洲裔拉丁裔美国人是预测因素，而抗疟药使用、医疗保障和达到标准的时间间隔较长是疾病早期疾病活动度较高的保护因素。
