Yeo, Ai Li 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 V. 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. (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; P¼0.008) and the persistently positive cohort (adjusted HR 1.36; 95% CI: 1.08, 1.71; P¼0.009). 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. © The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology.
| Item Type: | Article |
|---|---|
| Funders: | Asia Pacific Lupus Collaboration |
| Additional Information: | Cited by: 2 |
| Uncontrolled Keywords: | Antibodies, Antinuclear; Data Collection; DNA; Hematologic Tests; Humans; Lupus Erythematosus, Systemic; antimalarial agent; azathioprine; belimumab; cyclophosphamide; cyclosporine; double stranded DNA antibody; leflunomide; methotrexate; mycophenolic acid; prednisolone; rituximab; tacrolimus; antinuclear antibody; DNA; adult; Article; cohort analysis; disease exacerbation; female; human; longitudinal study; major clinical study; male; risk assessment; serology; systemic lupus erythematosus; blood examination; information processing |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Medicine Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 15 Nov 2024 09:06 |
| Last Modified: | 15 Nov 2024 09:06 |
| URI: | http://eprints.um.edu.my/id/eprint/44878 |
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