Disease activity and damage accrual during the early disease course in a multinational inception cohort of patients with systemic lupus erythematosus

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dc.contributor.author Nossent, J en
dc.contributor.author Kiss, E en
dc.contributor.author Rozman, B en
dc.contributor.author Pokorny, G en
dc.contributor.author Vlachoyiannopoulos, P en
dc.contributor.author Olesinska, M en
dc.contributor.author Marchesoni, A en
dc.contributor.author Mosca, M en
dc.contributor.author Pai, S en
dc.contributor.author Manger, K en
dc.contributor.author Schneider, M en
dc.contributor.author Nielsen, H en
dc.contributor.author van Vollenhoven, R en
dc.contributor.author Swaak, T en
dc.date.accessioned 2014-03-01T02:00:21Z
dc.date.available 2014-03-01T02:00:21Z
dc.date.issued 2010 en
dc.identifier.issn 0961-2033 en
dc.identifier.uri http://hdl.handle.net/123456789/29090
dc.subject damage accrual en
dc.subject disease activity en
dc.subject Europe en
dc.subject inception cohort en
dc.subject systemic lupus erythematosus en
dc.subject therapy en
dc.subject.classification Rheumatology en
dc.subject.other 3 ETHNIC-GROUPS en
dc.subject.other EULAR STANDING COMMITTEE en
dc.subject.other REVISED CRITERIA en
dc.subject.other MORTALITY en
dc.subject.other INDEX en
dc.subject.other MANIFESTATIONS en
dc.subject.other CLASSIFICATION en
dc.subject.other PROGNOSIS en
dc.subject.other DIAGNOSIS en
dc.title Disease activity and damage accrual during the early disease course in a multinational inception cohort of patients with systemic lupus erythematosus en
heal.type journalArticle en
heal.language English en
heal.publicationDate 2010 en
heal.abstract An inception cohort of patients with systemic lupus erythematosus from 14 European centres was followed for up to 5 years in order to describe the current early disease course. At inclusion patients (n = 200, 89% female, mean age 35 years, 97% Caucasian, mean SLEDAI 12.2) fulfilled a mean of 6.5 ACR classification criteria. The most prevalent criteria were antinuclear Ab presence (97%) followed by anti-dsDNA Ab (74%), arthritis (69%), leukocytopenia (54%) and malar rash (53%), antiphospholipid Ab (48%) and anti-synovial membrane Ab (21.6%). Clinical signs of lupus nephritis (LN) were present in 39% with biopsy-confirmed LN seen in 25%. Frequent additional findings were hypocomplementaemia (54%), anti-SSA Ab (49%), alopecia (26%) and Raynaud's phenomenon (31%). There were few regional differences in disease presentation and management. One and 5-year survival rates were 99% and 97% respectively. During the mean follow-up of 4.1 years 25% entered a state of early disease quiescence by global physician assessment, but the overall risk of subsequent flare was 60%. Maximum SLEDAI scores decreased over time, but 45% of patients accrued damage (SDI >= 1) for which baseline presence of proteinuria and persistent disease activity were independent predictors. The results indicate minor differences in SLE presentation and treatment within various regions of Europe and a high diagnostic reliance on anti-dsDNA Ab. Despite early reductions in disease activity and improved mortality, the risk for disease flare and damage development is, however, still substantial, especially in patients not entering an early remission. Lupus (2010) 19, 949-956. en
heal.publisher SAGE PUBLICATIONS LTD en
heal.journalName LUPUS en
dc.identifier.isi ISI:000279121200008 en
dc.identifier.volume 19 en
dc.identifier.issue 8 en
dc.identifier.spage 949 en
dc.identifier.epage 956 en

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