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TOPLINE:

A threshold of sustained lupus low disease activity state (LLDAS) or remission for 3 months significantly reduces the risk for damage accrual and flares in patients with systemic lupus erythematosus (SLE), with longer durations offering even greater protection. 

METHODOLOGY:

  • This large, prospective, multicenter study aimed to quantify the impact of sustained LLDAS on irreversible damage and flares.
  • It included 3449 patients (age, ≥ 18 years; 92.2% women) with SLE from 25 centers across 12 countries, analyzing a total of 37,662 visits.
  • Sustained LLDAS or remission was defined as at least two consecutive visits over > 3 months in the respective state.
  • The primary outcome measured was the accrual of irreversible organ damage, with flares as a key secondary outcome.

TAKEAWAY:

  • During a median follow-up of 2.8 years, 80.2% of patients achieved LLDAS at least once, with 72.7% experiencing at least one episode of sustained LLDAS.
  • Sustained LLDAS for > 3 months was linked to a reduced risk for damage accrual (hazard ratio [HR], 0.60; P < .0001).
  • Protection from flares also increased with all durations of sustained LLDAS > 3 months (> 3 months: HR, 0.56; P < .0001; > 36 months: HR, 0.17; P < .0001).
  • Longer periods of sustained LLDAS or remission were associated with significantly higher degrees of protection.

IN PRACTICE:

“These findings support the use of these treat-to-target endpoints in clinical practice and provide a practical target to aim for in SLE treatment,” the authors wrote. 

SOURCE:

The study was led by Vera Golder, MBBS, Monash University, Clayton, Australia. It was published online in The Lancet Rheumatology

LIMITATIONS:

While the study’s large scale and multinational cohort provided robust data, its observational design limited the ability to establish causality. The predominance of Asian ethnicity among the participants may have affected the generalizability of the findings to other populations. Additionally, the median follow-up duration of 2.8 years might not have captured long-term outcomes.

DISCLOSURES:

Some authors declared receiving grants, consulting fees, payments, and honoraria and having other ties with various sources. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article appeared on Medscape.com.

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TOPLINE:

A threshold of sustained lupus low disease activity state (LLDAS) or remission for 3 months significantly reduces the risk for damage accrual and flares in patients with systemic lupus erythematosus (SLE), with longer durations offering even greater protection. 

METHODOLOGY:

  • This large, prospective, multicenter study aimed to quantify the impact of sustained LLDAS on irreversible damage and flares.
  • It included 3449 patients (age, ≥ 18 years; 92.2% women) with SLE from 25 centers across 12 countries, analyzing a total of 37,662 visits.
  • Sustained LLDAS or remission was defined as at least two consecutive visits over > 3 months in the respective state.
  • The primary outcome measured was the accrual of irreversible organ damage, with flares as a key secondary outcome.

TAKEAWAY:

  • During a median follow-up of 2.8 years, 80.2% of patients achieved LLDAS at least once, with 72.7% experiencing at least one episode of sustained LLDAS.
  • Sustained LLDAS for > 3 months was linked to a reduced risk for damage accrual (hazard ratio [HR], 0.60; P < .0001).
  • Protection from flares also increased with all durations of sustained LLDAS > 3 months (> 3 months: HR, 0.56; P < .0001; > 36 months: HR, 0.17; P < .0001).
  • Longer periods of sustained LLDAS or remission were associated with significantly higher degrees of protection.

IN PRACTICE:

“These findings support the use of these treat-to-target endpoints in clinical practice and provide a practical target to aim for in SLE treatment,” the authors wrote. 

SOURCE:

The study was led by Vera Golder, MBBS, Monash University, Clayton, Australia. It was published online in The Lancet Rheumatology

LIMITATIONS:

While the study’s large scale and multinational cohort provided robust data, its observational design limited the ability to establish causality. The predominance of Asian ethnicity among the participants may have affected the generalizability of the findings to other populations. Additionally, the median follow-up duration of 2.8 years might not have captured long-term outcomes.

DISCLOSURES:

Some authors declared receiving grants, consulting fees, payments, and honoraria and having other ties with various sources. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article appeared on Medscape.com.

 

TOPLINE:

A threshold of sustained lupus low disease activity state (LLDAS) or remission for 3 months significantly reduces the risk for damage accrual and flares in patients with systemic lupus erythematosus (SLE), with longer durations offering even greater protection. 

METHODOLOGY:

  • This large, prospective, multicenter study aimed to quantify the impact of sustained LLDAS on irreversible damage and flares.
  • It included 3449 patients (age, ≥ 18 years; 92.2% women) with SLE from 25 centers across 12 countries, analyzing a total of 37,662 visits.
  • Sustained LLDAS or remission was defined as at least two consecutive visits over > 3 months in the respective state.
  • The primary outcome measured was the accrual of irreversible organ damage, with flares as a key secondary outcome.

TAKEAWAY:

  • During a median follow-up of 2.8 years, 80.2% of patients achieved LLDAS at least once, with 72.7% experiencing at least one episode of sustained LLDAS.
  • Sustained LLDAS for > 3 months was linked to a reduced risk for damage accrual (hazard ratio [HR], 0.60; P < .0001).
  • Protection from flares also increased with all durations of sustained LLDAS > 3 months (> 3 months: HR, 0.56; P < .0001; > 36 months: HR, 0.17; P < .0001).
  • Longer periods of sustained LLDAS or remission were associated with significantly higher degrees of protection.

IN PRACTICE:

“These findings support the use of these treat-to-target endpoints in clinical practice and provide a practical target to aim for in SLE treatment,” the authors wrote. 

SOURCE:

The study was led by Vera Golder, MBBS, Monash University, Clayton, Australia. It was published online in The Lancet Rheumatology

LIMITATIONS:

While the study’s large scale and multinational cohort provided robust data, its observational design limited the ability to establish causality. The predominance of Asian ethnicity among the participants may have affected the generalizability of the findings to other populations. Additionally, the median follow-up duration of 2.8 years might not have captured long-term outcomes.

DISCLOSURES:

Some authors declared receiving grants, consulting fees, payments, and honoraria and having other ties with various sources. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article appeared on Medscape.com.

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