Lupus & antiphospholipid syndrome
Early systemic lupus erythematosus (SLE) may follow a fast comorbidity/multimorbidity trajectory associated with flare burden and glucocorticoid exposure
Authors' conclusion
Nearly half of patients with newly diagnosed SLE show accelerated comorbidity and multimorbidity burden, underscoring the need for clinical vigilance. Fast-accrual phenotypes are linked to flares and glucocorticoid exposure, two potentially modifiable features of early disease.
Study context
- Population
- Patients with SLE ≤2 years from diagnosis, 5-year monitoring of 140 comorbiditiesinception cohort
- Participants
- 311 patients
- Exposure
- Fast vs slow incident-comorbidity trajectories
- Outcome
- Trajectories of incident comorbidities and multimorbidity profiles
- Follow-up
- 5 years
Methodological detailsgrowth mixture modelling, tetrachoric exploratory factor analysis followed by clustering, penalised multivariable regression
- Growth mixture modelling
- Tetrachoric exploratory factor analysis followed by clustering
- Penalised multivariable regression
Main finding
As reported in the abstract
| Outcome | Values |
|---|---|
| Values | Slow 55% · Fast 45% · Fast/low-to-moderate 51% · multimorbidity (≥2 conditions) 32.7% · Metabolic-psychiatric 31% · multimorbidity (≥2 conditions) 65.7% · Cardiopulmonary-musculoskeletal 18% · multimorbidity (≥2 conditions) 100% |
Observational data: associations, not effects.
Further findings
Predictors of fast-comorbidity trajectory (first 24 months)
| OR (95% CI) | ||
|---|---|---|
| Severe flares (≥20% of time)Independently predicted | 2.10 (1.09–4.04) | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | OR (per 10 mg/day) (95% CI) | |
|---|---|---|
| Predictors of fast-comorbidity trajectory (first 24 months)GC exposure · independently predicted | 1.06 (1.01–1.11) | |
| 0.512Odds ratio (log scale) |
| Outcome | IRR |
|---|---|
| Organ damageFast vs Slow | 2.28-3.27 |
- Organ damage: range across fast-accruing groups, especially metabolic-psychiatric and cardiopulmonary-musculoskeletal
Organ damage
- Fast accruers attained less LLDAS/DORIS
Predictors of fast-comorbidity trajectory (first 24 months)
- Flares more prominent in fast/low-to-moderate and metabolic-psychiatric phenotypes; GC use more prominent in cardiopulmonary-musculoskeletal phenotype
Safety
| Outcome | IRR |
|---|---|
| Safety-related eventsFast vs Slow · range across fast-accruing groups | 1.89-3.36 |
Original publication
Early SLE may follow a fast comorbidity/multimorbidity trajectory associated with flare burden and glucocorticoid exposure. RMD Open. Published 23 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →