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Prediction of Damage Accrual in Systemic Lupus Erythematosus Using the Systemic Lupus International Collaborating Clinics Frailty Index
Author(s) -
Legge Alexandra,
Kirkland Susan,
Rockwood Kenneth,
Andreou Pantelis,
Bae SangCheol,
Gordon Caroline,
RomeroDiaz Juanita,
SanchezGuerrero Jorge,
Wallace Daniel J.,
Bernatsky Sasha,
Clarke Ann E.,
Merrill Joan T.,
Ginzler Ellen M.,
Fortin Paul R.,
Gladman Dafna D.,
Urowitz Murray B.,
Bruce Ian N.,
Isenberg David A.,
Rahman Anisur,
Alarcón Graciela S.,
Petri Michelle,
Khamashta Munther A.,
Dooley M. A.,
RamseyGoldman Rosalind,
Manzi Susan,
Zoma Asad A.,
Aranow Cynthia,
Mackay Meggan,
RuizIrastorza Guillermo,
Lim S. Sam,
Inanc Murat,
Vollenhoven Ronald F.,
Jonsen Andreas,
Nived Ola,
RamosCasals Manuel,
Kamen Diane L.,
Kalunian Kenneth C.,
Jacobsen Soren,
Peschken Christine A.,
Askanase Anca,
Hanly John G.
Publication year - 2020
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.41144
Subject(s) - medicine , interquartile range , systemic lupus , systemic lupus erythematosus , cohort , confidence interval , rheumatology , accrual , disease , earnings , accounting , business
Objective The Systemic Lupus International Collaborating Clinics ( SLICC ) frailty index ( FI ) has been shown to predict mortality, but its association with other important outcomes is unknown. We examined the association of baseline SLICC FI values with damage accrual in the SLICC inception cohort. Methods The baseline visit was defined as the first visit at which both organ damage ( SLICC /American College of Rheumatology Damage Index [ SDI ]) and health‐related quality of life (Short Form 36) were assessed. Baseline SLICC FI scores were calculated. Damage accrual was measured by the increase in SDI between the baseline assessment and the last study visit. Multivariable negative binomial regression was used to estimate the association between baseline SLICC FI values and the rate of increase in the SDI during follow‐up, adjusting for relevant demographic and clinical characteristics. Results The 1,549 systemic lupus erythematosus ( SLE ) patients eligible for this analysis were mostly female (88.7%) with a mean ± SD age of 35.7 ± 13.3 years and a median disease duration of 1.2 years (interquartile range 0.9–1.5 years) at baseline. The mean ± SD baseline SLICC FI was 0.17 ± 0.08. Over a mean ± SD follow‐up of 7.2 ± 3.7 years, 653 patients (42.2%) had an increase in SDI . Higher baseline SLICC FI values (per 0.05 increase) were associated with higher rates of increase in the SDI during follow‐up (incidence rate ratio [ IRR ] 1.19 [95% confidence interval 1.13–1.25]), after adjusting for age, sex, ethnicity/region, education, baseline SLE Disease Activity Index 2000, baseline SDI , and baseline use of glucocorticoids, antimalarials, and immunosuppressive agents. Conclusion Our findings indicate that the SLICC FI predicts damage accrual in incident SLE , which further supports the SLICC FI as a valid health measure in SLE .