The Lupus Foundation of America-Rapid Evaluation of Activity in Lupus Clinician-Reported Outcome Predicts Damage in Patients With Systemic Lupus Erythematosus. Data From the Almenara Lupus Cohort.

IF 2.4 4区 医学 Q2 RHEUMATOLOGY JCR: Journal of Clinical Rheumatology Pub Date : 2024-08-01 Epub Date: 2024-06-17 DOI:10.1097/RHU.0000000000002102
Manuel F Ugarte-Gil, Rocío V Gamboa-Cárdenas, Cristina Reátegui-Sokolova, Victor R Pimentel-Quiroz, Claudia Elera-Fitzcarrald, César Pastor-Asurza, Zoila Rodriguez-Bellido, Risto Perich-Campos, Graciela S Alarcón
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Abstract

Objective: To evaluate the predictive value of the LFA-REAL ClinRO (Lupus Foundation of America Rapid Evaluation of Activity in Lupus clinician-reported outcome) on damage accrual in systemic lupus erythematosus patients.

Methods: Data from a prevalent lupus cohort were used. The LFA-REAL ClinRO includes 9 domains: mucocutaneous (global and 3 subdomains), musculoskeletal (global and 2 subdomains), cardiorespiratory, neuropsychiatric, renal, hematological, constitutional, vasculitis, and other (it allows for other or rare manifestations). For each domain, a 0- to 100-mm visual analog scale is used, and global domains are included except for the mucocutaneous and musculoskeletal domains where the subdomains are included; it allows for 3 manifestations under "other," so the score ranges from 0 to 1400 (sum of 14 in the visual analog scale). Damage was assessed with the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index. Generalized estimating equations were performed, being the outcome the increase in the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index; confounders from the previous visit were included; adjusted multivariable models were done. Incidence rate ratios per 10-unit increase in the LFA-REAL ClinRO were reported. Similar models were performed to evaluate the impact of the SLEDAI-2K (SLE Disease Activity Index) and physician global assessment on damage to determine which measure would better predict damage accrual.

Results: Three-hundred thirty-one patients and 1425 visits were included, 1.9 (SD 1.2) years of follow-up. Disease duration at baseline was 10.7 (7.4) years. The mean LFA-REAL ClinRO was 18.2 (SD 30.7). During the follow-up visits, 63 (17.9%) patients accrued damage once; 4 (1.1%) accrued damage twice. The LFA-REAL ClinRO was predictive of damage accrual even after adjustment for possible confounders (incidence rate ratio 1.10 (95% confidence interval 1.04-1.16; p < 0.001). Similar results were obtained using the SLEDAI-2K and the physician global assessment.

Conclusion: The LFA-REAL ClinRO is predictive of damage accrual, even after adjusting for possible confounders.

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美国狼疮基金会-狼疮活动快速评估临床医生报告结果预测系统性红斑狼疮患者的损害。来自阿尔梅纳拉狼疮队列的数据。
目的评估 LFA-REAL ClinRO(美国狼疮基金会狼疮活动快速评估临床医生报告结果)对系统性红斑狼疮患者损害累积的预测价值:方法:采用狼疮流行人群的数据。LFA-REAL ClinRO 包括 9 个领域:粘膜(总体和 3 个子领域)、肌肉骨骼(总体和 2 个子领域)、心肺、神经精神、肾脏、血液、体质、血管炎和其他(允许其他或罕见表现)。每个领域均使用 0 至 100 毫米的视觉模拟量表,除粘膜和肌肉骨骼领域包括子领域外,其他领域均包括总体领域;在 "其他 "项下允许有 3 种表现,因此得分范围为 0 至 1400(视觉模拟量表中 14 种表现的总和)。损害用系统性红斑狼疮国际合作诊所/美国风湿病学会损害指数进行评估。以系统性红斑狼疮国际合作诊所/美国风湿病学会损害指数的增加为结果,进行了广义估计方程计算;将前次就诊的混杂因素包括在内;建立了调整后的多变量模型。报告了LFA-REAL ClinRO每增加10个单位的发病率比。类似的模型还用于评估SLEDAI-2K(系统性红斑狼疮疾病活动指数)和医生对损害的总体评估的影响,以确定哪种指标能更好地预测损害的累积:结果:共纳入 331 名患者和 1425 次就诊,随访时间为 1.9 年(SD 1.2)。基线病程为 10.7 (7.4) 年。LFA-REAL ClinRO的平均值为18.2(标准差为30.7)。在随访期间,63 名患者(17.9%)出现了一次损伤;4 名患者(1.1%)出现了两次损伤。即使在调整了可能的混杂因素后,LFA-REAL ClinRO 仍能预测损害的累积(发病率比为 1.10(95% 置信区间为 1.04-1.16;P < 0.001)。使用SLEDAI-2K和医生总体评估也得出了类似的结果:结论:即使在调整了可能的混杂因素后,LFA-REAL ClinRO仍能预测损害的累积。
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来源期刊
CiteScore
3.50
自引率
2.90%
发文量
228
审稿时长
4-8 weeks
期刊介绍: JCR: Journal of Clinical Rheumatology the peer-reviewed, bimonthly journal that rheumatologists asked for. Each issue contains practical information on patient care in a clinically oriented, easy-to-read format. Our commitment is to timely, relevant coverage of the topics and issues shaping current practice. We pack each issue with original articles, case reports, reviews, brief reports, expert commentary, letters to the editor, and more. This is where you''ll find the answers to tough patient management issues as well as the latest information about technological advances affecting your practice.
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