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

Nossent, J; Kiss, E; Rozman, B; Pokorny, G; Vlachoyiannopoulos, P; Olesinska, M; Marchesoni, A; Mosca, M; Pai, S; Manger, K; Schneider, M; Nielsen, H; van Vollenhoven, R; Swaak, T

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	https://dspace.lib.ntua.gr/xmlui/handle/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	COLLABORATING CLINICS/AMERICAN-COLLEGE	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