Long-term prognosis and factors associated with damage accrual in Japanese patients with systemic lupus erythematosus
Using a single-center cohort of Japanese patients with SLE, we attempted to clarify the long-term outcome and factors associated with damage accrual using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI).
We examined a cohort of 557 patients who had been referred to Niigata University Hospital and diagnosed as having SLE between 1961 and 2013. The patients’ data at the latest visit were collected from their clinical records, and causes of death were defined on the basis of those data. Survival from the time of diagnosis was calculated by the Kaplan–Meier method. The SDI was calculated and analyzed using Spearman’s correlation coefficient and stepwise multiple regression analysis to reveal the factors associated with any organ damage.
Data from 458 of the patients were successfully obtained. The overall 5-year survival rate was 92.2%, and patients diagnosed after 2000 had a significantly high 5-year survival rate of 96.4%. Stepwise multiple regression analysis selected serum creatinine levels (B = 0.6051, p < 0.0001), age (standardized beta = 0.2762, p < 0.001), hypertension (standardized beta = 0.2267, p < 0.001), and antiphospholipid antibody syndrome (standardized beta = 0.1533, p = 0.005) as positive independent variables, whereas administration of bisphosphonate (standardized beta = − 0.1295, p = 0.016) was selected as a negative independent variable.
These results suggest that Japanese patients with SLE have a favorable long-term prognosis, and also indicate that disease control as well as management of chronic complications such as hypertension and osteoporosis has possible effects for prevention of organ damage.
KeywordsSystemic lupus erythematosus SLICC/ACR Damage Index (SDI) Hypertension Bisphosphonate
We are grateful to Professor Naohito Tanabe, University of Niigata Prefecture, for his kind advice regarding statistical analyses in this study.
Compliance with ethical standards
Conflict of interest
All authors do not have any conflict of interest regarding to the study.
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee at which the studies were conducted (IRB approval number 1754) and with the Declaration of Helsinki and the ethical guidelines for epidemiological studies issued by the Ministry of Health, Labour and Welfare of Japan.
Because data were retrospectively obtained from medical records, informed consent was not obtained in accordance with the above ethical guidelines.
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