TY - JOUR T1 - Persistent Disease Activity Remains a Burden for Patients with Systemic Lupus Erythematosus JF - The Journal of Rheumatology JO - J Rheumatol SP - 166 LP - 175 DO - 10.3899/jrheum.171454 VL - 46 IS - 2 AU - Christine A. Peschken AU - Yishu Wang AU - Michal Abrahamowicz AU - Janet Pope AU - Earl Silverman AU - Amyn Sayani AU - Sandra Iczkovitz AU - Jorge Ross AU - Michel Zummer AU - Lori Tucker AU - Christian Pineau AU - Deborah Levy AU - Marie Hudson AU - Carol A. Hitchon AU - Adam M. Huber AU - C. Douglas Smith AU - Antonio Avina-Zubieta AU - Hector Arbillaga AU - Gaëlle Chédeville AU - Willy Wynant AU - Paul R. Fortin AU - on behalf of CaNIOS 1000 Faces Investigators Y1 - 2019/02/01 UR - http://www.jrheum.org/content/46/2/166.abstract N2 - Objective. Persistent systemic lupus erythematosus (SLE) disease activity is associated with increased morbidity and mortality. In a multicenter cohort of patients with prevalent SLE, we described persistence, patterns, and predictors of change in disease activity over time.Methods. Based on SLE Disease Activity Index (SLEDAI)-2K scores at cohort entry, patients were classified into 4 groups: low (score < 4; LOW), moderate (4 to < 6; MOD), moderately high (6 to ≤ 10; MHIGH), and very high (> 10; VHIGH). Multivariable linear and longitudinal mixed linear regression models were used to identify predictors of change over time in SLEDAI-2K.Results. There were 2019 participants, with declining followup data over 5 years (1326, 580, 274, 186, and 148 patients, respectively). At cohort entry, mean (± SD) age was 42 (± 17) years, disease duration 11 (± 10) years, and 90% were female. The 4 groups included 44% LOW (n = 891), 20% MOD (n = 400), 22% MHIGH (n = 442), and 14% VHIGH (n = 286); therefore, 36% had clinically important SLE activity. The proportion of patients in the LOW group at entry who moved to a higher activity level varied from 30% (167/557) at 1 year, to 49% (41/83) at 3 years, and 54% (30/56) at 5 years. Among 181 patients with MOD to VHIGH entry activity and 3 years of followup, 116 (64.1%) remained active. In all analyses, only higher SLEDAI-2K at cohort entry remained a significant predictor of higher SLEDAI-2K in subsequent years.Conclusion. Higher SLEDAI-2K at study entry was the single major independent predictor of higher SLEDAI-2K over time, reflecting frequent persistence of active disease, even in patients with longstanding disease. This highlights gaps in the optimal treatment of SLE. ER -