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2016, Number 1

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Rev cubana med 2016; 55 (1)

Identification of relapse aerological predictors in patients with systemic lupus erythematous: a prospective study of 12 months

Kokuina E, Estévez TM, Gutiérrez RÁ, Ortiz LA, Sánchez BY, Pérez CD, Argüelles ZA, Chico CA, Casas FN

Language: Spanish
References: 51
Page: 30-45
PDF size: 226.92 Kb.


ABSTRACT

Introduction: the research carried out have not been successful in finding serological biomarkers or sufficiently reliable biomarkers for predicting relapse in systemic lupus erythematosus (SLE).
Objective: setermine the predictive value of specific antinuclear antibodies for relapse of SLE and lupus nephritis.
Methods: an analytical, observational, longitudinal and prospective study was carried out in 120 adult patients with inactive SLE (SLEDAI-2K ≤ 5 points). The baseline presence of seven antinuclear specificities, low C3 and C4 were correlated with the occurrence of SLE relapse (increases in score SLEDAI-2K ≥ 4) and lupus nephritis by univariate analysis. The most valuable variables were further evaluated as predictors a multivariate logistic regression model to calculate the odds ratio (OR).
Results: SLE and lupus nephritis relapses were observed in 51 (42.5 %) and 29 (24.2 %) patients, respectively. The presence of anti-Nu (OR= 1523.0, P ‹ 0.001) antibodies and anti-dsDNA (OR= 12.1; p = 0.044) and lupus nephritis, anti-Nu (OR= 92.9; p ‹ 0.001) and low C3 (OR= 7.1; p= 0.007) emerged as risk factors for relapse of SLE in multivariate analysis. The underrepresentation of anti-RNP was a risk factor for relapse of SLE and lupus nephritis (OR = 0.023; p= 0.009; OR = 0.1; p= 0.025).
Conclusions: SLE patients with positive anti-Nu, anti-dsDNA and low levels of C3 had a higher risk of relapse of SLE and lupus nephritis in the succeeding 12 months, signaling the need for close clinical monitoring.


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