Lupus Patients Can Have Active Disease Activity Even After Prolonged Treatment

Dr. Christine A. Peschken from the University of Manitoba in Winnipeg presented data on lupus disease in a Canadian cohort of patients, during the 70th Annual Meeting of The Canadian Rheumatology Association (CRA) in Quebec, Canada. The poster was entitled “Residual Lupus Disease Activity in a Large Canadian Cohort of Prevalent Patients”.

Systemic lupus erythematosus (SLE), commonly referred to as lupus, is a severe autoimmune disease in which the body’s own immune system overreacts producing autoantibodies and attacking healthy joints and organs, which ultimately leads to inflammation, swelling, pain, disability and often tissue destruction in multiple organs.

SLE treatment intends to effectively control disease activity and prevent tissue damage. Residual disease activity has, however, been reported. According to a news release, Dr. Peschken’s study assessed residual disease activity, damage and treatment in a large multi-center cohort of 1,454 SLE patients. The mean age of the cohort was 44 years, the mean disease duration 10.6 years, and 90.3% of the patients were females.

Researchers reported that at baseline, 655 patients (nearly half of the cohort) had low disease activity, 288 patients had moderate disease activity, 318 had active disease activity and 193 highly active disease activity. Mean disease duration was found to decrease significantly, with an observed increased disease activity of 11.3 years for the low activity group and 9.1 years for the highest activity group. In terms of damage, scores were found to be higher in the groups with higher disease activity, although they were not clinically significantly different between high and low disease activity groups.

In terms of treatment, the use of cyclophosphamide or prednisone was found to be linked to a higher disease activity, while antimalarial drugs were linked to a lower disease activity. No differences in age, sex or education were found between the different groups.

The team concluded that in the patient cohort analyzed, a higher disease activity was associated with shorter disease duration, increased damage and higher use of cyclophosphamide and prednisone. Active lupus was found in 35% of the patients even after a mean of 11 years of disease. The authors believe that these results highlight the need to optimize lupus patients’ treatment.