Lupus & antiphospholipid syndrome
SMART-SLE: serology monitoring and repeat testing in systemic lupus erythematosus—an analysis of anti-double-stranded DNA monitoring
Authors' conclusion
Absolute value and change in anti-dsDNA titres predict flares, including in persistently anti-dsDNA positive patients.
Study context
- Population
- SLE patients in a multinational longitudinal cohort with known anti-dsDNA results, 2013–2021
- Participants
- 3,484 patients37,582 visits
- Exposure
- Anti-dsDNA ratio to normal cut-off >3 and >2-fold change from previous visit, by anti-dsDNA pattern (persistently negative, fluctuating, persistently positive)
- Persistently positiven = 1,029
- Fluctuatingn = 1,195
- Outcome
- Subsequent flare
Methodological detailsmultinational, longitudinal, Cox regression
- Multinational
- Longitudinal
- Cox regression
Main finding
As reported in the abstract
Flare with anti-dsDNA ratio to normal cut-off >3
Adjusted hazard ratio (95% CI)P value
Persistently positive
1.56(1.30–1.87)
P < 0.001Fluctuating
1.46(1.28–1.66)
Observational data: associations, not effects.
Further findings
Flare with >2-fold increase or decrease in anti-dsDNA vs previous visit
| aHR (95% CI) | P value | ||
|---|---|---|---|
| Fluctuating | 1.33 (1.08–1.65) | P = 0.008 | |
| Persistently positive | 1.36 (1.08–1.71) | P = 0.009 | |
| 0.512Adjusted hazard ratio (log scale) |
Original publication
SMART-SLE: serology monitoring and repeat testing in systemic lupus erythematosus—an analysis of anti-double-stranded DNA monitoring. Rheumatology (Oxford). Published 19 May 2023. doi:10.
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