Li, Ning and Hoi, Alberta and Luo, Shue-Fen and Wu, Yeong-Jian Jan and Louthrenoo, Worawit and Golder, Vera and Sockalingam, Sargunan and Cho, Jiacai and Lateef, Aisha and O'Neill, Sean and Lau, Chak Sing and Hamijoyo, Laniyati and Nikpour, Mandana and Oon, Shereen and Hao, Yanjie and Chan, Madelynn and Li, Zhanguo and Navarra, Sandra and Zamora, Leonid and Katsumata, Yasuhiro and Harigai, Masayoshi and Goldblatt, Fiona and Bae, Sang-Cheol and Zhang, Zhuoli and Takeuchi, Tsutomu and Kikuchi, Jun and Ng, Kristine and Tugnet, Nicola and Tanaka, Yoshiya and Ohkubo, Naoaki and Chen, Yi-Hsing and Basnayake, B. M. D. B. and Law, Annie and Kumar, Sunil and Tee, Cherica and Tee, Michael Lucas and Choi, Jiyoon and Kandane-Rathnayake, Rangi and Morand, Eric (2025) Time trends of variability in disease activity in systemic lupus erythematosus. Lupus Science & Medicine, 12 (1). e001335. ISSN 2053-8790, DOI https://doi.org/10.1136/lupus-2024-001335.
Full text not available from this repository.Abstract
Objective Disease activity both between and within patients with SLE is highly variable, yet factors driving this variability remain unclear. This study aimed to identify predictors of variability in SLE disease activity over time. Methods We analysed data from 2930 patients with SLE across 13 countries, collected over 38 754 clinic visits between 2013 and 2020. Clinic visit records were converted to panel data with 1-year intervals. The time-adjusted mean disease activity, termed AMS, was calculated. The yearly change in AMS, denoted as Delta AMSt, was regressed onto AMSt-1 and other potential predictors using random-effects models. Some variables were split into a person-mean component to assess between-patient differences and a demeaned component to assess within-patient variability. Results Overall, variability in SLE disease activity exhibited stabilisation over time. A significant inverse relationship emerged between a patient's disease activity in a given year and variability in disease activity in the subsequent year: a 1-point increase in person-mean disease activity was associated with a 0.27-point decrease (95% CI -0.29 to -0.26, p<0.001) in subsequent variability. Additionally, a 1-point increase in within-patient disease activity variability was associated with a 0.56-point decrease (95% CI -0.57 to -0.55, p<0.001) in the subsequent year. Furthermore, each 1-point increase in the annual average time-adjusted mean Physician Global Assessment was associated with a 0.08-point decrease (90% CI -0.13 to -0.03, p=0.002) in disease activity variability for the following year. Prednisolone dose and the duration of activity in specific organ systems exhibited negative and positive associations, respectively, with disease activity variability in the subsequent year. Patients from less affluent countries displayed greater disease activity variability compared with those from wealthier nations. Conclusion Disease activity tends to be less variable among patients with higher or more variable disease activity in the previous year. Within-patient variability in disease activity has a stronger impact on subsequent fluctuations than differences between individual patients.
| Item Type: | Article |
|---|---|
| Funders: | Bristol-Myers Squibb (IM011-164), AstraZeneca, Bristol-Myers Squibb, EMD Serono, GlaxoSmithKline, Johnson & Johnson Johnson & Johnson USA Janssen Biotech Inc, Eli Lilly, UCB Pharma SA, Ministry of Education (MOE), Republic of Korea National Research Foundation of Korea (NRF-2021R1A6A1A03038899) |
| Uncontrolled Keywords: | Lupus Erythematosus, Systemic; Severity of Illness Index; Outcome Assessment, Health Care |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Universiti Malaya |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 30 Apr 2025 04:31 |
| Last Modified: | 30 Apr 2025 04:31 |
| URI: | http://eprints.um.edu.my/id/eprint/47891 |
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