Autoantibody-based subgroups and longitudinal seroconversion in juvenile-onset systemic lupus erythematosus
Authors' conclusion
In children with SLE, subgroups based on autoantibody profile can be applied to differentiate phenotypes and disease activity. Two important organ involvements, LN and NPSLE, are more common in patients with positive anti-Sm/RNP autoantibodies.
Study context
- Population
- Patients with juvenile-onset SLE (JSLE)
- Participants
- 87 patients
- Exposure
- Autoantibody-based subgroups (positive vs negative anti-Sm/RNP); positive/negative seroconversion vs no seroconversion
- Outcome
- Clinical phenotype and disease activity by autoantibody subgroup
Methodological detailstwo-step cluster analysis, Kaplan-Meier with log-rank test
- Two-step cluster analysis
- Kaplan-Meier with log-rank test
Main finding
As reported in the abstract
- More lupus nephritis (LN) and neuropsychiatric SLE (NPSLE) cases in subgroup 1 than in subgroup 2
- Higher SLEDAI scores in subgroup 1 than in subgroup 2
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Flare-free survival by seroconversionPositive seroconversion vs No seroconversion and negative seroconversion | P < 0.001 |
- Flare-free survival by seroconversion: significantly lower flare-free survival with positive seroconversion; log-rank test
Most commonly positive autoantibodies at baseline
- Anti-ribosomal P protein
- 61.1%
- Anti-nucleosome
- 58.3%
- Anti-dsDNA
- 54%
Remaining positive in fifth year of follow-up
- Anti-dsDNA
- 27.27%
- Anti-nucleosome
- 38.89%
- Anti-ribosomal P protein
- 45.00%
- Progressive decrease in positive results during follow-up; for those negative at baseline, decrease in negative results progressive but modest
Original publication
Autoantibody-based subgroups and longitudinal seroconversion in juvenile-onset systemic lupus erythematosus. Lupus Sci Med. Published 3 April 2023. doi:10.
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