RT Journal Article
SR Electronic
T1 More Consistent Antimalarial Intake in First 5 Years of Disease Is Associated with Better Prognosis in Patients with Systemic Lupus Erythematosus
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 90
OP 94
DO 10.3899/jrheum.170645
VO 45
IS 1
A1 Rattapol Pakchotanon
A1 Dafna D. Gladman
A1 Jiandong Su
A1 Murray B. Urowitz
YR 2018
UL http://www.jrheum.org/content/45/1/90.abstract
AB Objective. To examine whether more consistent use of antimalarial agents (AM) leads to better results in systemic lupus erythematosus (SLE).Methods. From a longitudinal cohort study, we identified inception patients with a minimum of 5 years of followup. They were divided into 3 groups: patients who took AM > 60% of the time (group A), those who took AM < 60% of the time (group B), and those who did not receive AM (group C) during the first 5 years of followup. Outcomes included increase in Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), flare, achieving low disease activity (LDA), adjusted mean Systemic Lupus Erythematosus Disease Activity Index 2000, cumulative doses of steroids (CMS), and AM-related retinal toxicity. Regression analysis models were constructed to identify predictors of the outcomes.Results. There were 459 patients identified: 236 (51.4%) in group A, 88 (19.2%) in group B, and 135 (29.4%) in group C. The changes in SDI, flare event, and CMS were significantly lower in group A, which more often achieved LDA. Multivariable analysis revealed that the patients in group A had a lower risk of increasing SDI and were more likely to achieve LDA at Year 5 compared to the patients in group C. Patients taking AM had lower CMS over the 5 years of followup. There was only 1 patient with AM-related retinal toxicity in each group.Conclusion. More consistent use of an AM over the first 5 years of SLE is associated with better outcomes.