A recent study established a significant link between disease flares and damage accrual in patients with systemic lupus erythematosus.
In the study, published in Lupus Science & Medicine, investigators analyzed data from 1,556 patients enrolled in the Asia Pacific Lupus Collaboration cohort, with a median follow-up of 5.7 years
The investigators revealed that 39.5% (n = 614) of patients had organ damage at the time of enrollment, and 31.9% (n = 496) of them accumulated further damage during the observation period. The incidence of damage accrual was estimated at 58 per 1,000 person-years. Notably, 74.1% (n = 1,153) of patients experienced at least one flare, with 56.9% (n = 885) enduring recurrent flares.
Further, the investigators found that flares were independently linked to a higher risk of damage accrual. The patients who experienced mild-to-moderate flares had a 32% increased risk of subsequent damage, with an adjusted hazard ratio (HR) of 1.32 (95% confidence interval [CI] = 1.17–1.72) compared with those without flares. Severe flares were associated with an even greater risk of damage accrual, with an HR of 1.58 (95% CI = 1.18–2.11).
For every additional flare experienced, the risk of damage accrual increased by 7% (HR = 1.07, 95% CI = 1.02–1.13), underscoring the cumulative effect of disease flares on long-term outcomes in patients with SLE.
"Flares independently increased the risk of damage accrual. Prevention of flares should be considered a necessary goal of SLE disease management to minimize permanent damage," said lead study author Rangi Kandane-Rathnayake, of the Rheumatology Research Group at the Centre for Inflammatory Diseases at the School of Clinical Sciences at Monash University in Australia, and colleagues.
While the study provided valuable insights into the relationship between flares and damage, further research is needed to explore the mechanisms underlying this association and develop more effective interventions to prevent flares in patients with SLE.
No conflicts of interest were reported in the study.
