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Prediction of Damage Accrual in Systemic Lupus Erythematosus Using the Systemic Lupus International Collaborating Clinics Frailty Index

Legge, Alexandra ; Kirkland, Susan ; Rockwood, Kenneth ; Andreou, Pantelis ; Bae, Sang Cheol ; Gordon, Caroline ; Romero-Diaz, Juanita ; Sanchez-Guerrero, Jorge ; Wallace, Daniel J. and Bernatsky, Sasha , et al. (2020) In Arthritis and Rheumatology 72(4). p.658-666
Abstract

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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Arthritis and Rheumatology
volume
72
issue
4
pages
9 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:31631584
  • scopus:85079433352
ISSN
2326-5191
DOI
10.1002/art.41144
language
English
LU publication?
yes
id
8768004e-7653-4ee0-8636-c3911f0e0809
date added to LUP
2020-02-24 16:03:46
date last changed
2022-09-24 04:44:39
@article{8768004e-7653-4ee0-8636-c3911f0e0809,
  abstract     = {{<p>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.</p>}},
  author       = {{Legge, Alexandra and Kirkland, Susan and Rockwood, Kenneth and Andreou, Pantelis and Bae, Sang Cheol and Gordon, Caroline and Romero-Diaz, Juanita and Sanchez-Guerrero, Jorge and Wallace, Daniel J. and Bernatsky, Sasha and Clarke, Ann E. and Merrill, Joan T. and Ginzler, Ellen M. and Fortin, Paul R. and Gladman, Dafna D. and Urowitz, Murray B. and Bruce, Ian N. and Isenberg, David A. and Rahman, Anisur and Alarcón, Graciela S. and Petri, Michelle and Khamashta, Munther A. and Dooley, M. A. and Ramsey-Goldman, Rosalind and Manzi, Susan and Zoma, Asad A. and Aranow, Cynthia and Mackay, Meggan and Ruiz-Irastorza, Guillermo and Lim, S. Sam and Inanc, Murat and van Vollenhoven, Ronald F. and Jonsen, Andreas and Nived, Ola and Ramos-Casals, Manuel and Kamen, Diane L. and Kalunian, Kenneth C. and Jacobsen, Soren and Peschken, Christine A. and Askanase, Anca and Hanly, John G.}},
  issn         = {{2326-5191}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{658--666}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Arthritis and Rheumatology}},
  title        = {{Prediction of Damage Accrual in Systemic Lupus Erythematosus Using the Systemic Lupus International Collaborating Clinics Frailty Index}},
  url          = {{http://dx.doi.org/10.1002/art.41144}},
  doi          = {{10.1002/art.41144}},
  volume       = {{72}},
  year         = {{2020}},
}