ArticleLupus science & medicine2020
High disease activity status suggests more severe disease and damage accrual in systemic lupus erythematosus.
Article in Lupus science & medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- The 2026 British Society for Rheumatology guideline for the management of children, young people and adults with systemic lupus erythematosus.Rheumatology (Oxford, England) · 2026Guideline
- High disease activity persists in adults with childhood-onset lupus.Lupus science & medicine · 2026Article
- Article
- Seroprotection after a Standard Three-Dose Hepatitis B Vaccination Series in Immune-Mediated Rheumatic Diseases: A Retrospective Observational Study.Infectious diseases & clinical microbiology · 2026Article
- Value of the Platelet-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Product in the Evaluation of Systemic Lupus Erythematosus Disease Activity.Journal of inflammation research · 2026Article
- Impact of high disease activity on damage accrual and disease outcomes in childhood-onset systemic lupus erythematosus.Frontiers in pediatrics · 2026Article
- Dysregulated soluble immune mediators and lupus-associated autoantibody specificities inform the development of immune indexes that characterise classified SLE transition and SLE disease activity.Lupus science & medicine · 2025Article
- Prevalence and outcomes of a pilot definition of severe refractory systemic lupus erythematosus: observations from a multinational Asia-Pacific cohort.Arthritis research & therapy · 2025Article
- The implication of anti-Ro60 with or without anti-Ro52 antibody in patients with systemic lupus erythematosus.Rheumatology (Oxford, England) · 2025Article
- Cumulative pulse methylprednisolone and its relation to disease activity, damage and mortality in systemic lupus erythematosus patients: A post hoc analysis of COMOSLE-EGYPT study.Clinical rheumatology · 2024Article
- Duplex Vertical-Flow Rapid Tests for Point-of-Care Detection of Anti-dsDNA and Anti-Nuclear Autoantibodies.Biosensors · 2024Article
- Mortality in a cohort of Egyptian systemic lupus erythematosus patients: A comparison with African, Arabic, and Mediterranean studies.Archives of rheumatology · 2023Article
- Predictors of severe lupus flare: a prospective follow-up study.BMC rheumatology · 2023Article
- A 5-Year Retrospective, Observational Study Assessing Rheumatoid Arthritis Disease Outcome Measures to Characterize Systemic Lupus Erythematosus Burden in the USA.Rheumatology and therapy · 2023Article
- Fibromyalgia, mood disorders, cognitive test results, cognitive symptoms and quality of life in systemic lupus erythematosus.Rheumatology (Oxford, England) · 2022Article
- Predictors of improvement in disease activity in first hospitalized patients with systemic lupus erythematosus: a multicenter retrospective study of a Chinese cohort.Clinical rheumatology · 2022Article
- Measurement of circulating CD21Scientific reports · 2022Article
- 'Not at target': prevalence and consequences of inadequate disease control in systemic lupus erythematosus-a multinational observational cohort study.Arthritis research & therapy · 2022Observational
- Evaluation of the Montreal Cognitive Assessment as a screening tool for cognitive dysfunction in SLE.Lupus science & medicine · 2021Article
- Disease course following High Disease Activity Status revealed patterns in SLE.Arthritis research & therapy · 2021Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveDisease severity in SLE is an important concept related to disease activity, treatment burden and prognosis. We set out to evaluate if high disease activity status (HDAS), based on ever attainment of a Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) disease activity score of ≥10, is an indicator for disease severity in SLE.
methodsUsing prospectively collected data, we assessed the association of HDAS with sociodemographic and disease characteristics and adverse clinical outcomes using logistic regression or generalised estimating equations.
resultsOf 286 patients with SLE, who were observed for a median (range) of 5.1 years (1-10.8 years), 43.7% experienced HDAS at least once during the observational period. Autoantibody positivity, particularly anti-dsDNA and anti-Sm positivity, were associated with increased likelihood of HDAS. Age ≥45 years at diagnosis was associated with reduced likelihood of HDAS (p=0.002). Patients with HDAS had higher Physician Global Assessment score (>1: OR 8.1, p<0.001) and were more likely to meet criteria for flare (mild/moderate flare: OR 4.4, p<0.001; severe flare: OR 17.2, p<0.001) at the time of experiencing HDAS. They were also more likely to have overall higher disease activity, as defined by time-adjusted mean SLEDAI-2K score in the highest quartile (OR 11.7, 95% CI 5.1 to 26.6; p>0.001), higher corticosteroid exposure (corticosteroid dose in highest quartile: OR 7.7, 95% CI 3.9 to 15.3; p<0.001) and damage accrual (OR 2.3, 95% CI 1.3 to 3.9; p=0.003) when compared with non-HDAS patients.
conclusionsHDAS is associated with more severe disease, as measured by higher disease activity across time, corticosteroid exposure and damage accrual. The occurrence of HDAS may be a useful prognostic marker in the management of SLE.
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