Observational studyArthritis research & therapy2022
'Not at target': prevalence and consequences of inadequate disease control in systemic lupus erythematosus-a multinational observational cohort study.
Observational study in Arthritis research & therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Management of systemic lupus erythematosus: a systematic literature review informing the 2023 update of the EULAR recommendations.Annals of the rheumatic diseases · 2024Pooled it
- Towards development of treat to target (T2T) in childhood-onset systemic lupus erythematosus: PReS-endorsed overarching principles and points-to-consider from an international task force.Annals of the rheumatic diseases · 2023Pooled it
- Deucravacitinib, a Tyrosine Kinase 2 Inhibitor, in Systemic Lupus Erythematosus: A Phase II, Randomized, Double-Blind, Placebo-Controlled Trial.Arthritis & rheumatology (Hoboken, N.J.) · 2023Trial
- Review of Promising Off-Label Use of Deucravacitinib.International journal of molecular sciences · 2025Review
- The Lupus Check 5 Tool: A Practical Approach to Initiating Treatment Reviews in Systemic Lupus Erythematosus.Rheumatology and therapy · 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 Expanding Therapeutic Potential of Deucravacitinib Beyond Psoriasis: A Narrative Review.Journal of clinical medicine · 2025Review
- Achievement of lupus low disease activity state (LLDAS) in a New Zealand cohort: a prospective study of ethnic differences in outcomes.Rheumatology advances in practice · 2025Article
- Clinical outcomes of baricitinib in patients with systemic lupus erythematosus: Pooled analysis of SLE-BRAVE-I and SLE-BRAVE-II trials.PloS one · 2025Article
- Belimumab in early systemic lupus erythematosus: A propensity score matching analysis.Immunity, inflammation and disease · 2024Article
- Pragmatic targets for moderate/severe SLE and their implications for clinical care and trial design: sustained DORIS or LLDAS for at least 6 months is sufficient while their attainment for at least 24 months ensures high specificity for damage-free progression.Annals of the rheumatic diseases · 2024Article
- Genetically predicted associations between circulating cytokines and autoimmune diseases: a bidirectional two-sample Mendelian randomization.Frontiers in immunology · 2024Article
- Case series: raw, whole, plant-based nutrition protocol rapidly reverses symptoms in three women with systemic lupus erythematosus and Sjögren's syndrome.Frontiers in nutrition · 2024Article
- Targeting DORIS Remission and LLDAS in SLE: A Review.Rheumatology and therapy · 2023Review
- Treat-to-Target in Pediatric Rheumatic Diseases.Current rheumatology reports · 2023Review
- Towards a novel clinical outcome assessment for systemic lupus erythematosus: first outcomes of an international taskforce.Nature reviews. Rheumatology · 2023Review
- Viewpoint on anifrolumab in patients with systemic lupus erythematosus and a high unmet need in clinical practice.RMD open · 2023Article
- Does expert opinion match the definition of lupus low disease activity state? Prospective analysis of 500 patients from a Spanish multicentre cohort.Rheumatology (Oxford, England) · 2023Article
- Renal outcomes in the long-term follow-up of lupus nephritis.Jornal brasileiro de nefrologiaObservational
Corrections and comments
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Authors and funding
37 authors at 20 institutions in 13 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe unmet need in systemic lupus erythematosus (SLE) with the current standard of care is widely recognised, but few studies have quantified this. The recent definition of treat-to-target endpoints and other thresholds of uncontrolled disease activity provide an opportunity to formally define unmet need in SLE. In this study, we enumerated the prevalence of these states and examined their association with adverse outcomes.
methodsData were collected prospectively in a 13-country longitudinal SLE cohort between 2013 and 2019. Unmet need was defined as never attaining lupus low disease activity state (LLDAS), a time-adjusted mean SLEDAI-2K (AMS) > 4, or ever experiencing high disease activity status (HDAS; SLEDAI-2K ≥10). Health-related quality of life (HRQoL) was assessed using SF36 (v2) and damage accrual using the SLICC-ACR SLE Damage Index (SDI).
resultsA total of 3384 SLE patients were followed over 30,313 visits (median [IQR] follow-up 2.4 [0.4, 4.3] years). Eight hundred thirteen patients (24%) never achieved LLDAS. Median AMS was 3.0 [1.4, 4.9]; 34% of patients had AMS > 4. Twenty-five per cent of patients had episodes of HDAS. Each of LLDAS-never, AMS>4, and HDAS-ever was strongly associated with damage accrual, higher glucocorticoid use, and worse HRQoL. Mortality was significantly increased in LLDAS-never (adjusted HR [95% CI] = 4.98 [2.07, 12.0], p<0.001) and HDAS-ever (adjusted hazard ratio (HR) [95% CI] = 5.45 [2.75, 10.8], p<0.001) patients.
conclusionFailure to achieve LLDAS, high average disease activity, and episodes of HDAS were prevalent in SLE and were significantly associated with poor outcomes including organ damage, glucocorticoid exposure, poor quality of life, and mortality.
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Registered trials
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