2019-EULAR/ACR classification criteria domains at diagnosis: predictive factors of long-term damage in systemic lupus erythematosus

Author(s)

Insfran, Carlos E. ^[1] ; Aikawa, Nadia E. ^{[1, 2]} ; Pasoto, Sandra G. ^[1] ; Filho, Dilson M. N. ^[1] ; Formiga, Francisco F. C. ^[1] ; Pitta, Ana C. ^{[1, 2]} ; Borba, Eduardo F. ^[1] ; Ribeiro, Carolina T. ^[1] ; Silva, Clovis A. ^{[1, 2]} ; Bonfa, Eloisa ^[1]

Affiliation

^[1] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Rheumatol Div, Av Dr Arnaldo 455, Sala 3190, BR-01246903 Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Childrens Inst, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: CLINICAL RHEUMATOLOGY; NOV 2021.
• Web of Science Citations: 0

Abstract

The objective of this study is to assess the role of the 2019-European League Against Rheumatism/American College of Rheumatology (2019-EULAR/ACR) classification criteria at diagnosis and its domains in predicting long-term damage in systemic lupus erythematosus(SLE). We performed a retrospective analysis using an electronic chart database utilized in routine clinical care of SLE patients and established in 2000 in a tertiary hospital. Two hundred and nine consecutive SLE patients with disease onset >= 18 years old and long disease duration were included. Cumulative damage at the last visit was scored using the SLICC/ACR-Damage Index (SDI). The median age at SLE diagnosis was 28 years (18-63), disease duration was 14 years (8-25), and 88% were females. Damage (SDI >= 1) was observed in 116/209 (55%). Patients with (SDI >= 1, n=116) and without damage (SDI=0, n=93) had similar median disease duration {[}14 (8-25) vs. 12 (8-25) years, p=0.090{[} and age at diagnosis {[}23 (18-55) vs. 23 (18-56) years, p=0.998{[}. No correlation was observed between total 2019-EULAR/ACR score at diagnosis and SDI at last visit (r=0.007, p=0.913). Presence of renal domain at diagnosis was associated with renal damage at last visit (OR=3.6, 95%CI 1.2-10.4, p=0.017) and antiphospholipid antibodies domain predicted neuropsychiatric damage (OR=3.0, 95%CI 1.2-7.6, p=0.015). A ROC analysis identified that a cut-off >24 in 2019-EULAR/ACR score could predict a trend for renal damage (p=0.077) with a lower renal survival (Kaplan-Meier curve) for patients above this limit (p=0.029). A multivariate logistic regression analysis revealed that 2019-EULAR/ACR score >24 at diagnosis (OR 4.583, 95%CI 1.052-19.962, p=0.043) was independently associated with renal damage. Specific domains in the 2019-EULAR/ACR criteria at diagnosis were associated with long-term organspecific damage, particularly renal and neuropsychiatric harm. A 2019-EULAR/ACR score >24 predicted worse renal survival. (AU)

• FAPESP's process: 18/16162-3 - Yellow fever and influenza 2018 vaccination campaign: safety and immunogenicity in patients with rheumatological autoimmune diseases
• Grantee: Eduardo Ferreira Borba Neto
• Support Opportunities: Regular Research Grants
• FAPESP's process: 15/03756-4 - Assessment of relevance of blood levels of drugs in the monitoring rheumatic autoimmune diseases: safety, effectiveness and adherence to therapy
• Grantee: Eloisa Silva Dutra de Oliveira Bonfá
• Support Opportunities: Research Projects - Thematic Grants