Li Yeo, Ai and Kandane-Rathnayake, Rangi and Koelmeyer, Rachel and Golder, Vera and Louthrenoo, Worawit and Chen, Yi-Hsing and Cho, Jiacai and Lateef, Aisha and Hamijoyo, Laniyati and Luo, Shue-Fen and Wu, Yeong-Jian J. and Navarra, Sandra and Zamora, Leonid and Li, Zhanguo and An, Yuan and Sockalingam, Sargunan and Katsumata, Yasuhiro and Harigai, Masayoshi and Hao, Yanjie and Zhang, Zhuoli and Basnayake, B. M. D. B. and Chan, Madelynn and Kikuchi, Jun and Takeuchi, Tsutomu and Bae, Sang-Cheol and Oon, Shereen and O'Neill, Sean and Goldblatt, Fiona and Ng, Kristine (Pek Ling) and Law, Annie and Tugnet, Nicola and Kumar, Sunil and Tee, Cherica and Tee, Michael and Ohkubo, Naoaki and Tanaka, Yoshiya and Lau, Chak Sing and Nikpour, Mandana and Hoi, Alberta and Leech, Michelle and Morand, Eric F. and Collaboration, Asia Pacific Lupus (2024) SMART-SLE: Serology monitoring and repeat testing in systemic lupus erythematosus: An analysis of anti-double-stranded DNA monitoring. Rheumatology, 63 (2). pp. 525-533. ISSN 1462-0324, DOI https://doi.org/10.1093/rheumatology/kead231.
Full text not available from this repository.Abstract
Objective Disease activity monitoring in SLE includes serial measurement of anti-double stranded-DNA (dsDNA) antibodies, but in patients who are persistently anti-dsDNA positive, the utility of repeated measurement is unclear. We investigated the usefulness of serial anti-dsDNA testing in predicting flare in SLE patients who are persistently anti-dsDNA positive. Methods Data were analysed from patients in a multinational longitudinal cohort with known anti-dsDNA results from 2013 to 2021. Patients were categorized based on their anti-dsDNA results as persistently negative, fluctuating or persistently positive. Cox regression models were used to examine longitudinal associations of anti-dsDNA results with flare. Results Data from 37 582 visits of 3484 patients were analysed. Of the patients 1029 (29.5%) had persistently positive anti-dsDNA and 1195 (34.3%) had fluctuating results. Anti-dsDNA expressed as a ratio to the normal cut-off was associated with the risk of subsequent flare, including in the persistently positive cohort (adjusted hazard ratio HR] 1.56; 95% CI: 1.30, 1.87; P < 0.001) and fluctuating cohort (adjusted HR 1.46; 95% CI: 1.28, 1.66), both for a ratio >3. Both increases and decreases in anti-dsDNA more than 2-fold compared with the previous visit were associated with increased risk of flare in the fluctuating cohort (adjusted HR 1.33; 95% CI: 1.08, 1.65; P = 0.008) and the persistently positive cohort (adjusted HR 1.36; 95% CI: 1.08, 1.71; P = 0.009). Conclusion Absolute value and change in anti-dsDNA titres predict flares, including in persistently anti-dsDNA positive patients. This indicates that repeat monitoring of dsDNA has value in routine testing.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | dsDNA positivity; Systemic lupus erythematosus; Test monitoring |
| Subjects: | R Medicine |
| Divisions: | Faculty of Medicine > Medicine Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 16 Jul 2024 03:21 |
| Last Modified: | 16 Jul 2024 07:28 |
| URI: | http://eprints.um.edu.my/id/eprint/46055 |
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