Early Discoid Lupus Erythematosus Protects Against Renal Disease In Patients With Systemic Lupus Erythematosus: Longitudinal Data From A Large Latin American Cohort

dc.creatorPons-Estel
dc.creatorG. J.; Aspey
dc.creatorL. D.; Bao
dc.creatorG.; Pons-Estel
dc.creatorB. A.; Wojdyla
dc.creatorD.; Saurit
dc.creatorV.; Alvarellos
dc.creatorA.; Caeiro
dc.creatorF.; Haye Salinas
dc.creatorM. J.; Sato
dc.creatorE. I.; Soriano
dc.creatorE. R.; Costallat
dc.creatorL. T. L.; Neira
dc.creatorO.; Iglesias-Gamarra
dc.creatorA.; Reyes-Llerena
dc.creatorG.; Cardiel
dc.creatorM. H.; Acevedo-Vasquez
dc.creatorE. M.; Chacon-Diaz
dc.creatorR.; Drenkard
dc.creatorC.
dc.date2017
dc.datejan
dc.date2017-11-13T13:12:40Z
dc.date2017-11-13T13:12:40Z
dc.date.accessioned2018-03-29T05:50:51Z
dc.date.available2018-03-29T05:50:51Z
dc.identifierLupus. Sage Publications Ltd, v. 26, p. 73 - 83, 2017.
dc.identifier0961-2033
dc.identifier1477-0962
dc.identifierWOS:000390847600010
dc.identifier10.1177/0961203316651740
dc.identifierhttp://journals.sagepub.com/doi/full/10.1177/0961203316651740
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/326923
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1363948
dc.descriptionThe objective of this study was to examine whether early discoid lupus erythematosus (DLE) would be a protective factor for further lupus nephritis in patients with systemic lupus erythematosus (SLE). Methods We studied SLE patients from GLADEL, an inception longitudinal cohort from nine Latin American countries. The main predictor was DLE onset, which was defined as physician-documented DLE at SLE diagnosis. The outcome was time from the diagnosis of SLE to new lupus nephritis. Univariate and multivariate survival analyses were conducted to examine the association of DLE onset with time to lupus nephritis. Results Among 845 GLADEL patients, 204 (24.1%) developed lupus nephritis after SLE diagnosis. Of them, 10 (4.9%) had DLE onset, compared to 83 (12.9%) in the group of 641 patients that remained free of lupus nephritis (hazard ratio 0.39; P=0.0033). The cumulative proportion of lupus nephritis at 1 and 5 years since SLE diagnosis was 6% and 14%, respectively, in the DLE onset group, compared to 14% and 29% in those without DLE (P=0.0023). DLE onset was independently associated with a lower risk of lupus nephritis, after controlling for sociodemographic factors and disease severity at diagnosis (hazard ratio 0.38; 95% confidence interval 0.20-0.71). Conclusions Our data indicate that DLE onset reduces the risk of further lupus nephritis in patients with SLE, independently of other factors such as age, ethnicity, disease activity, and organ damage. These findings have relevant prognosis implications for SLE patients and their clinicians. Further studies are warranted to unravel the biological and environmental pathways associated with the protective role of DLE against renal disease in patients with SLE.
dc.description26
dc.description1
dc.description73
dc.description83
dc.descriptionFederico Wilhelm Agricola Foundation Research
dc.descriptionSTELLAR (Supporting Training Efforts in Lupus for Latin-American Rheumatologists) Program - Rheuminations, Inc.
dc.descriptionInstitut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS)-Beca de Formacio i Contractacio de Personal Investigador
dc.descriptionNIH [R01AR065493]
dc.descriptionCDC [U01-DP14-004]
dc.languageEnglish
dc.publisherSage Publications LTD
dc.publisherLondon
dc.relationLupus
dc.rightsfechado
dc.sourceWOS
dc.subjectSystemic Lupus Erythematosus
dc.subjectLupus Nephritis
dc.subjectDiscoid Lupus Erythematosus
dc.subjectSurvival Analysis
dc.subjectGladel Cohort
dc.titleEarly Discoid Lupus Erythematosus Protects Against Renal Disease In Patients With Systemic Lupus Erythematosus: Longitudinal Data From A Large Latin American Cohort
dc.typeArtículos de revistas


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