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Prediction of Damage Accrual in Systemic Lupus Erythematosus Using the Systemic Lupus International Collaborating Clinics Frailty Index

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

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  • Alexandra Legge
  • Susan Kirkland
  • Kenneth Rockwood
  • Pantelis Andreou
  • Sang-Cheol Bae
  • Caroline Gordon
  • Juanita Romero-Diaz
  • Jorge Sanchez-Guerrero
  • Daniel J Wallace
  • Sasha Bernatsky
  • Ann E Clarke
  • Joan T Merrill
  • Ellen M Ginzler
  • Paul R Fortin
  • Dafna D Gladman
  • Murray B Urowitz
  • Ian N Bruce
  • David A Isenberg
  • Anisur Rahman
  • Graciela S Alarcón
  • Michelle Petri
  • Munther A Khamashta
  • M A Dooley
  • Rosalind Ramsey-Goldman
  • Susan Manzi
  • Asad A Zoma
  • Cynthia Aranow
  • Meggan Mackay
  • Guillermo Ruiz-Irastorza
  • S Sam Lim
  • Murat Inanc
  • Ronald F van Vollenhoven
  • Andreas Jonsen
  • Ola Nived
  • Manuel Ramos-Casals
  • Diane L Kamen
  • Kenneth C Kalunian
  • Soren Jacobsen
  • Christine A Peschken
  • Anca Askanase
  • John G Hanly
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OBJECTIVE: The Systemic Lupus International Collaborating Clinics (SLICC) frailty index (FI) has been shown to predict mortality, but its association with other important outcomes is unknown. We examined the association of baseline SLICC FI values with damage accrual in the SLICC inception cohort.

METHODS: The baseline visit was defined as the first visit at which both organ damage (SLICC/American College of Rheumatology Damage Index [SDI]) and health-related quality of life (Short Form 36) were assessed. Baseline SLICC FI scores were calculated. Damage accrual was measured by the increase in SDI between the baseline assessment and the last study visit. Multivariable negative binomial regression was used to estimate the association between baseline SLICC FI values and the rate of increase in the SDI during follow-up, adjusting for relevant demographic and clinical characteristics.

RESULTS: The 1,549 systemic lupus erythematosus (SLE) patients eligible for this analysis were mostly female (88.7%) with a mean ± SD age of 35.7 ± 13.3 years and a median disease duration of 1.2 years (interquartile range 0.9-1.5 years) at baseline. The mean ± SD baseline SLICC FI was 0.17 ± 0.08. Over a mean ± SD follow-up of 7.2 ± 3.7 years, 653 patients (42.2%) had an increase in SDI. Higher baseline SLICC FI values (per 0.05 increase) were associated with higher rates of increase in the SDI during follow-up (incidence rate ratio [IRR] 1.19 [95% confidence interval 1.13-1.25]), after adjusting for age, sex, ethnicity/region, education, baseline SLE Disease Activity Index 2000, baseline SDI, and baseline use of glucocorticoids, antimalarials, and immunosuppressive agents.

CONCLUSION: Our findings indicate that the SLICC FI predicts damage accrual in incident SLE, which further supports the SLICC FI as a valid health measure in SLE.

Original languageEnglish
JournalArthritis and Rheumatology
Volume72
Issue number4
Pages (from-to)658-666
Number of pages9
ISSN2326-5191
DOIs
Publication statusPublished - Apr 2020

    Research areas

  • Adult, Disease Progression, Female, Frailty/diagnosis, Humans, Immunosuppressive Agents/therapeutic use, Lupus Erythematosus, Systemic/diagnosis, Male, Middle Aged, Quality of Life, Severity of Illness Index, Young Adult

ID: 61876934