| Title: |
SMART-SLE: serology monitoring and repeat testing in systemic lupus erythematosus—an analysis of anti-double-stranded DNA monitoring |
| Authors: |
Yeo, AL; Kandane-Rathnayake, R; Koelmeyer, R; Golder, V; Louthrenoo, W; Chen, YH; Cho, J; Lateef, A; Hamijoyo, L; Luo, SF; Wu, YJJ; Navarra, SV; Zamora, L; Li, Z; An, Y; Sockalingam, S; Katsumata, Y; Harigai, M; Hao, Y; Zhang, Z; Basnayake, BMDB; Chan, M; Kikuchi, J; Takeuchi, T; Bae, SC; Oon, S; O’Neill, S; Goldblatt, F; Ng, KPL; Law, A; Tugnet, N; Kumar, S; Tee, C; Tee, M; Ohkubo, N; Tanaka, Y; Lau, CS; Nikpour, M; Hoi, A; Leech, M; Morand, EF |
| Publisher Information: |
OXFORD UNIV PRESS |
| Publication Year: |
2024 |
| Collection: |
The University of Melbourne: Digital Repository |
| Description: |
OBJECTIVE: Disease activity monitoring in SLE includes serial measurement of anti-double stranded-DNA (dsDNA) antibodies, but in patients who are persistently anti-dsDNA positive, the utility of repeated measurement is unclear. We investigated the usefulness of serial anti-dsDNA testing in predicting flare in SLE patients who are persistently anti-dsDNA positive. METHODS: Data were analysed from patients in a multinational longitudinal cohort with known anti-dsDNA results from 2013 to 2021. Patients were categorized based on their anti-dsDNA results as persistently negative, fluctuating or persistently positive. Cox regression models were used to examine longitudinal associations of anti-dsDNA results with flare. RESULTS: Data from 37 582 visits of 3484 patients were analysed. Of the patients 1029 (29.5%) had persistently positive anti-dsDNA and 1195 (34.3%) had fluctuating results. Anti-dsDNA expressed as a ratio to the normal cut-off was associated with the risk of subsequent flare, including in the persistently positive cohort (adjusted hazard ratio [HR] 1.56; 95% CI: 1.30, 1.87; P < 0.001) and fluctuating cohort (adjusted HR 1.46; 95% CI: 1.28, 1.66), both for a ratio >3. Both increases and decreases in anti-dsDNA more than 2-fold compared with the previous visit were associated with increased risk of flare in the fluctuating cohort (adjusted HR 1.33; 95% CI: 1.08, 1.65; P = 0.008) and the persistently positive cohort (adjusted HR 1.36; 95% CI: 1.08, 1.71; P = 0.009). CONCLUSION: Absolute value and change in anti-dsDNA titres predict flares, including in persistently anti-dsDNA positive patients. This indicates that repeat monitoring of dsDNA has value in routine testing. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
1462-0324 |
| Relation: |
pii: 7174139; https://hdl.handle.net/11343/350792 |
| Availability: |
https://hdl.handle.net/11343/350792 |
| Rights: |
https://creativecommons.org/licenses/by/4.0 ; CC BY |
| Accession Number: |
edsbas.575F977C |
| Database: |
BASE |