Lupus & antiphospholipid syndrome
Clinical characteristics and response to standard-of-care treatment in systemic lupus erythematosus patients with or without anti-ribonucleoprotein (RNP) antibodies: an Australian, multi-centre cohort study
Authors' conclusion
Anti-RNP positive patients presented with a higher burden of disease activity, and required more intensive treatment with glucocorticoids and immunosuppressants during the first year since study of follow-up, but this was largely driven by the strong association of anti-RNP positivity with anti-Sm positivity.
Study context
- Population
- Adult patients with systemic lupus erythematosus (SLE) in a national, multicentre registry, Australia, 2007–2023
- Participants
- 587 patients
- Exposure
- Anti-RNP positive vs anti-RNP negative SLE patients
- RNP +n = 174
- Outcome
- Clinical characteristics incl. disease activity (SLEDAI-2K, PGA), medication use and treat-to-target (T2T) states (lupus low disease activity state (LLDAS), DORIS remission) at enrolment, 6 and 12 months
Methodological detailsnational, multicentre registry, prospectively collected 2007–2023
- National, multicentre registry
- Prospectively collected 2007–2023
Main finding
As reported in the abstract
Values · enrolment RNP + 29.6% (95% CI 26.1%–33.4%)
SLEDAI-2K median [IQR] RNP + 8.0 [4.0, 10.0] · RNP- 4.0 [2.0, 8.0]
PGA median [IQR] RNP + 0.9 [0.4, 1.2] · RNP- 0.5 [0.2, 1.0]
Daily GC dose median [IQR], mg/day RNP + 6.8 [0.0, 15.0] · RNP- 3.0 [0.0, 10.0]
Active disease (SLEDAI-2K ≥ 6)
LLDAS
REM
- RNP + vs RNP-: P < 0.001
- RNP + vs RNP-: P < 0.001
- RNP + vs RNP-: P < 0.001
- RNP + vs RNP-: P < 0.007
- RNP + vs RNP-: P = 0.004
- RNP + vs RNP-: P = 0.006
Observational data: associations, not effects.
Further findings
Anti-Sm positivity
- RNP + patients 18-fold more likely to be anti-Sm positive; associations with disease activity attenuated on adjustment; highest disease activity in RNP + Sm +
- 18
Disease activity and treatment over follow-up · 12 months
- Disease activity indicators between RNP + and RNP- converged within the first 12 months
- GC and immunosuppressant use remained significantly higher in RNP + Sm + patients
Original publication
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