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DISEASE ACTIVITY AND DAMAGE INDEX IN 110 SLE PATIENTS

Felina Anić ; Reumatology and Clinial Immunology Department, KBC Rijeka, University of Medicne Rijeka, Croatia
Srđan Novak ; Reumatology and Clinial Immunology Department, KBC Rijeka, University of Medicne Rijeka, Croatia

Sažetak

Assessment of disease activity and accumulated damage in systemic lupus erythematosus (SLE) patients is important for the successful treatment management. In 1996 Systemic Lupus International Collaborating Clinics (SLICC)/ American College of Rheumatology (ACR) damage indeks (SDI) has been developed to assess irreversible damage in SLE patients, independently of its cause.Th e maximum possible score is 47. The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) is one of the standard scales used to assess the activity of the disease. The maximum possible score of SELENA / SLEDAI index is 105. The first classification criteria for SLE were developed in 1971, revised in 1982, and adopted by ACR in 1997. They were revised and validated by SLICC group in 2012. SLICC classification criteria improved the clinical relevance of the ACR criteria.
Objectives:
1) to determine SLICC/ACR damage index score in all patients,
2) to determine the prevalence and the correlation between both classification criteria and activity of disease and 3) to determine the correlation between activity and damage index with duration of disease.
Methods: We performed a cross-sectional analysis of 110 consecutive patients with SLE who were examined by physicians at our hospital center during the period of 3 months. SLEDAI index, SDI and the total number of ACR and SLICC classification criteria were determined.
Results: Median SLICC/ACR damage index score of all SLE patients was 2 (IQR 0-3). The most frequently observed organ systems were musculoskeletal, then neuropsychiatric, ocular, pulmonary, cardiovascular, renal and malignancy. The most frequently observed components of SLICC/ACR damage index were osteoporosis with fracture or vertebral collapse and cranial or peripheral neuropathy. The number of SLICC classification criteria met per patient was significantly higher than the number of ACR criteria (7[IQR 6-8] vs 5[IQR 4-6], P<0,001). Moderate corellation were detected between the number of SLICC classification criteria and disease activity index, both in case of active (r=0.48, P=0.003) and inactive disease (r=0.43 P<0,001).Tthere was a good correlation between SLICC/ACR damage index and disease duration (r=0.63, P<0.001). Conclusions: Patients with longer duration of disease had a larger damage index score. SLICC classificatio criteria correlate with disease activity because they capture more manifestations also included in the SLEDAI index.
References:
1. Lam GKV, Petri M. Assessment of systemic lupus erythematosus. Clin Exp Rheumatol 2005;23:120–32.
2. Griffi ths B, Mosca M, Gordon C. Assessment of patients with systemic lupus erythematosus and the use of lupus disease activity indices.
Best Pract Res Clin Rheumatol 2005;19:685–708.
3. Gladman DD, Urowitz MB, Rahman P, Ibanez D, Tam LS. Accrual of organ damage over time in patients with systemic lupus erythematosus.
J Rheumatol. 2003;30:1955–9.
4. Anić F, Žuvić-Butorac M, Štimac D, Novak S. New classifi cation criteria for systemic lupus erythematosus correlate with disease activity.
Croat Med J. 2014;55:514–9.

Ključne riječi

Hrčak ID:

210515

URI

https://hrcak.srce.hr/210515

Datum izdavanja:

5.12.2018.

Posjeta: 746 *