Ullah Saadat, Haroon Muhammad, Hashmi Farzana, Tayyab Zaid, Javed Saba
Division of Rheumatology, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, PAK.
Cureus. 2022 Jul 29;14(7):e27430. doi: 10.7759/cureus.27430. eCollection 2022 Jul.
Background and objective Systemic lupus erythematosus (SLE) is one of the most devastating systemic autoimmune connective tissue diseases. There is a paucity of prospective data on Pakistani SLE patients, and in this prospective study, we aimed to investigate the disease course, clinical outcomes, and the predictors of poor outcomes in a random population-based cohort of newly diagnosed SLE patients (diagnosed within the last one year). Methods This was a prospective observational study carried out in the rheumatology department of the Fatima Memorial Hospital, Lahore. Lupus patients are regularly reviewed in our dedicated lupus clinic every one to three months. For the purpose of this study, a focus group of newly diagnosed patients (diagnosed within the last one year) attending our lupus clinic was identified and prospectively followed up for 12 months. A wide range of demographical and clinical parameters was recorded. The association of clinical variables with the progressive disease was determined using univariate and multivariate logistic regressions. Results Prospective data of 89 newly diagnosed SLE patients regularly attending our dedicated lupus clinic were reviewed. During the study period, (January 2021 through January 2022), these patients had multiple visits overall - median: five, minimum: three, and maximum: nine visits [interquartile range (IQR) 4-7]. All 89 patients had completed one year of follow-up. Of note, 46% of the cohort was noted to have an ongoing active disease during the majority of visits in the study period. On multiple logistic regression analysis, there was a significant association between ongoing active disease ("progressors") and low education status [odds ratio (OR): 2.81, 95% confidence interval (CI): 1.01-7.76, p=0.046], stress at home (OR: 5.8, 95% CI: 2.13-15.8, p=0.001), and hematologic manifestations (OR: 3.0, 95% CI: 1.08-8.32, p=0.03). Conclusions Almost half of our cohort of lupus patients demonstrated active disease manifestations throughout the one-year prospective follow-up, and these were found to be associated with low education status, stress at home, and hematological manifestations.
背景与目的 系统性红斑狼疮（SLE）是最具破坏性的系统性自身免疫性结缔组织病之一。关于巴基斯坦SLE患者的前瞻性数据匮乏，在这项前瞻性研究中，我们旨在调查一组基于人群随机抽样的新诊断SLE患者（在过去一年内确诊）的疾病进程、临床结局以及不良结局的预测因素。方法 这是一项在拉合尔法蒂玛纪念医院风湿科进行的前瞻性观察性研究。狼疮患者每1至3个月在我们专门的狼疮门诊接受定期复查。为了本研究的目的，确定了一组在我们狼疮门诊就诊的新诊断患者（在过去一年内确诊），并对其进行了为期12个月的前瞻性随访。记录了广泛的人口统计学和临床参数。使用单变量和多变量逻辑回归确定临床变量与疾病进展的关联。结果 对89例定期到我们专门的狼疮门诊就诊的新诊断SLE患者的前瞻性数据进行了回顾。在研究期间（2021年1月至2022年1月），这些患者总体上进行了多次就诊——中位数：5次，最少：3次，最多：9次[四分位间距（IQR）4 - 7]。所有89例患者均完成了一年的随访。值得注意的是，在研究期间的大多数就诊中，该队列中有46%的患者被发现患有活动性疾病。在多变量逻辑回归分析中，活动性疾病（“进展者”）与低教育水平[比值比（OR）：2.81，95%置信区间（CI）：1.01 - 7.76，p = 0.046]、家庭压力（OR：5.8，95% CI：2.13 - 15.8，p = 0.001）以及血液学表现（OR：3.0，95% CI：1.08 - 8.32，p = 0.03）之间存在显著关联。结论 在我们的狼疮患者队列中，几乎一半的患者在为期一年的前瞻性随访中均表现出活动性疾病表现，并且发现这些与低教育水平、家庭压力和血液学表现有关。
