Lupus & antiphospholipid syndrome
Relapses are common in severe hematologic systemic lupus erythematosus and may be prevented by early institution of immunosuppressive agents: Α real-life single-center study
Authors' conclusion
Severe hematologic disease in SLE has a high risk of relapse, which may be mitigated by the early institution of GC-sparing agents.
Study context
- Population
- Patients in the "Attikon" lupus cohort with a history of severe haematologic manifestation (autoimmune hemolytic anemia (AIHA) with Hb < 8 g/dL, thrombocytopenia < 30,000/mm³, Evans syndrome, neutropenia < 500/mm³, thrombotic microangiopathy (TMA)/thrombotic thrombocytopenic purpura (TTP)-like syndrome or macrophage activation syndrome (MAS)); 70.7% women, mean (SD) age at systemic lupus erythematosus (SLE) diagnosis 42.6 (18.0) yearsfrom over 300 with haematologic manifestations
- Participants
- 41 patients
- Exposure
- SLE patients who relapsed vs those who did not relapse after initial treatment of a severe haematologic manifestation
- Relapsen = 22
- Outcome
- Relapse after initial treatment
Methodological detailssingle-centre, real-life
- Single-centre
- Real-life
Main finding
As reported in the abstract
Relapse after initial treatment
22
53.7%
Observational data: associations, not effects.
Further findings
Concomitant immunosuppressive agents after treatment of initial episode
P = 0.005
- Concomitant immunosuppressive agents after treatment of initial episode: relapsed less often received concomitant immunosuppressive agents; printed as n = 17/23 vs 5/17
Type of severe haematologic manifestation
- Thrombocytopenia (most common)
- 56.1%
- AIHA
- 17.1%
- TTP-like syndrome
- 12.2%
Timing of haematologic manifestation relative to SLE diagnosis
- Preceded SLE diagnosis
- 13 (31.7%)
- Concomitant to SLE diagnosis
- 16 (39%)
- During disease course (mean [SD] disease duration 8.7 [5.5] years)
- 12 (29.3%)
Initial treatment
- All patients treated with glucocorticoids (GC); RTX and CYC the most frequently used immunosuppressive agents
Original publication
Relapses are common in severe hematologic systemic lupus erythematosus and may be prevented by early institution of immunosuppressive agents: Α real-life single-center study. Lupus. Published 9 December 2022. doi:10.
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