ArticleArthritis and rheumatism2009
Frequency and determinants of flare and persistently active disease in systemic lupus erythematosus.
Article in Arthritis and rheumatism, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
46 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Safety, Tolerability, and Pharmacokinetics of NIM-1324 an Oral LANCL2 Agonist in a Randomized, Double-Blind, Placebo-Controlled Phase I Clinical Trial.Clinical and translational science · 2025Trial
- Effects of transitional care on self-care, readmission rates, and quality of life in adult patients with systemic lupus erythematosus: a randomized controlled trial.Arthritis research & therapy · 2018Trial
- Clinical associations of IL-10 and IL-37 in systemic lupus erythematosus.Scientific reports · 2016Trial
- Trial
- Associations between hydroxychloroquine dose and risk of flares in systemic lupus erythematosus.BMC rheumatology · 2025Article
- Article
- IgG glycosylation profiling of systemic lupus erythematosus using lectin microarray.Lupus science & medicine · 2025Article
- Frequency and Determinants of Flare and Persistently Active Disease in a Large Multinational Prospective Lupus Cohort.ACR open rheumatology · 2025Article
- Obinutuzumab in systemic lupus erythematosus: a real-world experience.Frontiers in immunology · 2025Article
- Identifying meaningful aspects of health and concepts of interest for assessment in systemic lupus erythematosus: implications for digital clinical measure development.Journal of patient-reported outcomes · 2024Article
- Favourable humoral but reduced cellular immune response to COVID-19 mRNA BNT162b2 vaccine in patients with childhood-onset systemic lupus erythematosus.Lupus science & medicine · 2024Article
- Global research trends in precision-targeted therapies for systemic lupus erythematosus (2003-2023): A bibliographic study.Heliyon · 2024Article
- Clinical trial outcomes for SLE: what we have and what we need.Lupus science & medicine · 2024Review
- Real-World Effectiveness of Belimumab in Patients with Active Lupus.Journal of clinical medicine · 2023Article
- Systemic lupus erythematosus with high disease activity identification based on machine learning.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2023Article
- Risk factors for 1-year hospital readmissions in patients with systemic lupus erythematosus.Clinical and experimental medicine · 2023Article
- Clinical analysis of patients with systemic lupus erythematosus complicated with liver failure.Clinical rheumatology · 2023Article
- Predictors of severe lupus flare: a prospective follow-up study.BMC rheumatology · 2023Article
- Evaluating disease control following belimumab treatment in patients with SLE enrolled in the US OBSErve study.Lupus science & medicine · 2022Observational
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveSelection of flare as the primary outcome variable in systemic lupus erythematosus (SLE) clinical trials fails to capture patients with persistently active disease (PAD). We sought to elucidate the frequency and determinants of flare and PAD.
methodsProspectively collected data from the Toronto Lupus Cohort were used to determine the incidence of flare and PAD in 2004 and 2005. Flare was defined as an increase in SLE Disease Activity Index 2000 update (SLEDAI-2K) score of >/=4 from the previous visit. PAD was defined as a SLEDAI-2K score of >/=4, excluding serology alone, on >/=2 consecutive visits. Data from 1, 2, and 3 years prior were used to model flare and PAD in 2004. Model properties were tested for prediction of flare and PAD in 2005.
resultsOne-third of the patients had >/=1 flare, whereas nearly half experienced PAD in a given year. Nearly 60% of the patients had episodes of flare or PAD per year. At least 25% of patients had PAD without achieving the definition of flare. In the best-fitting model, predictors of PAD in 2004 were SLEDAI-2K score at the start of the outcome interval and prior cutaneous or musculoskeletal disease activity. This model gave 79% correct prediction of PAD in 2005. In contrast, flare prediction models performed poorly.
conclusionPersistent activity is a common disease state in SLE and should be an outcome variable in SLE clinical trials. Our PAD prediction model may aid prognostication and selection of patients for inclusion in clinical trials.
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