From Childhood to Adulthood: Disease Activity Trajectories in Childhood-Onset Systemic Lupus Erythematosus.
Objective: No previous study has studied the longitudinal disease course of childhood-onset systemic lupus erythematosus (cSLE). Our objectives are to assess distinguishable differences in disease activity trajectories in cSLE patients, determine baseline factors predictive of disease trajectory mem...
| Publicado en: | Arthritis Care & Research Vol. 70; no. 5; pp. 750 - 758 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
May2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=129323760&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 129323760 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 2151464X B8M4 jtl: Arthritis Care & Research issn: 2151464X maglogo: N pubinfo: dt: May2018 vid: 70 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 129323760 129323760 NLM28704581 129323760 10.1002/acr.23319 NLM28704581 129323760 ppf: 750 ppct: 8 formats: tig: atl: From Childhood to Adulthood: Disease Activity Trajectories in Childhood-Onset Systemic Lupus Erythematosus. aug: au: Lim, Lily Siok Hoon Pullenayegum, Eleanor Feldman, Brian M. Lim, Lillian Gladman, Dafna D. Silverman, Earl D. affil: University of Manitoba, Winnipeg, Manitoba, Canada, and Institute of Health Policy Management & Evaluation, Toronto, Ontario, Canada sug: subj: Lupus Erythematosus, Systemic Classification Ontario Lupus Erythematosus, Systemic Epidemiology Female Child Adolescence Prospective Studies Male Models, Statistical Human Validation Studies Comparative Studies Evaluation Research Multicenter Studies Questionnaires Funding Source Child: 6-12 years Adolescent: 13-18 years Female Male ab: Objective: No previous study has studied the longitudinal disease course of childhood-onset systemic lupus erythematosus (cSLE). Our objectives are to assess distinguishable differences in disease activity trajectories in cSLE patients, determine baseline factors predictive of disease trajectory membership, and assess if the different disease activity trajectories are associated with different damage trajectories.Methods: This is a retrospective, longitudinal inception cohort of cSLE patients. Patients were followed from diagnosis as children, until they were adults. SLE disease activity was modeled as a latent characteristic, jointly using the Systemic Lupus Erythematosus Disease Activity Index 2000 and prednisone in a Bayesian growth mixture model. Baseline factors were tested for membership prediction of the latent classes of disease trajectories. Differences in damage trajectories by disease activity classes were tested using a mixed model.Results: A total of 473 patients (82% females), with median age at diagnosis of 14.1 years, were studied. We studied 11,992 visits (2,666 patient-years). We identified 5 classes of disease activity trajectories. Baseline major organ involvement, number of American College of Rheumatology criteria, and age at diagnosis predicted memberships into different classes. A higher proportion of Asians was in class 2 compared to class 5. Class 1 was associated with the most accrual of damage, while class 5 was associated with no significant damage accrual, even after 10 years.Conclusion: There are 5 distinct latent classes of disease trajectory in patients with cSLE. Membership within disease trajectories is predicted by baseline clinical and demographic factors. Membership in different disease activity trajectory classes is associated with different damage trajectories. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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