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Osteopontin and Disease Activity in Patients with Recent-onset Systemic Lupus Erythematosus: Results from the SLICC Inception Cohort

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  • Lina Wirestam
  • Helena Enocsson
  • Thomas Skogh
  • Leonid Padyukov
  • Andreas Jönsen
  • Murray B Urowitz
  • Dafna D Gladman
  • Juanita Romero-Diaz
  • Sang-Cheol Bae
  • Paul R Fortin
  • Jorge Sanchez-Guerrero
  • Ann E Clarke
  • Sasha Bernatsky
  • Caroline Gordon
  • John G Hanly
  • Daniel Wallace
  • David A Isenberg
  • Anisur Rahman
  • Joan Merrill
  • Ellen Ginzler
  • Graciela S Alarcón
  • W Winn Chatham
  • Michelle Petri
  • Munther Khamashta
  • Cynthia Aranow
  • Meggan Mackay
  • Mary Anne Dooley
  • Susan Manzi
  • Rosalind Ramsey-Goldman
  • Ola Nived
  • Kristjan Steinsson
  • Asad Zoma
  • Guillermo Ruiz-Irastorza
  • Sam Lim
  • Ken Kalunian
  • Murat Inanc
  • Ronald van Vollenhoven
  • Manuel Ramos-Casals
  • Diane L Kamen
  • Søren Jacobsen
  • Christine Peschken
  • Anca Askanase
  • Thomas Stoll
  • Ian N Bruce
  • Jonas Wetterö
  • Christopher Sjöwall
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OBJECTIVE: In cross-sectional studies, elevated osteopontin (OPN) levels have been proposed to reflect, and/or precede, progressive organ damage and disease severity in systemic lupus erythematosus (SLE). We aimed, in a cohort of patients with recent-onset SLE, to determine whether raised serum OPN levels precede damage and/or are associated with disease activity or certain disease phenotypes.

METHODS: We included 344 patients from the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort who had 5 years of followup data available. All patients fulfilled the 1997 American College of Rheumatology (ACR) criteria. Baseline sera from patients and from age- and sex-matched population-based controls were analyzed for OPN using ELISA. Disease activity and damage were assessed at each annual followup visit using the SLE Disease Activity Index 2000 (SLEDAI-2K) and the SLICC/ACR damage index (SDI), respectively.

RESULTS: Compared to controls, baseline OPN was raised 4-fold in SLE cases (p < 0.0001). After relevant adjustments in a binary logistic regression model, OPN levels failed to significantly predict global damage accrual defined as SDI ≥ 1 at 5 years. However, baseline OPN correlated with SLEDAI-2K at enrollment into the cohort (r = 0.27, p < 0.0001), and patients with high disease activity (SLEDAI-2K ≥ 5) had raised serum OPN (p < 0.0001). In addition, higher OPN levels were found in patients with persistent disease activity (p = 0.0006), in cases with renal involvement (p < 0.0001) and impaired estimated glomerular filtration rate (p = 0.01).

CONCLUSION: The performance of OPN to predict development of organ damage was not impressive. However, OPN associated significantly with lupus nephritis and with raised disease activity at enrollment, as well as over time.

Original languageEnglish
JournalJournal of Rheumatology
Issue number5
Pages (from-to)492-500
Number of pages9
Publication statusPublished - May 2019

ID: 58901645