Lupus Low-disease Activity State Can Predict Flare-up Risk

Asia-Pacific Lupus Collaborative's low-disease activity score can predict risk of flare-ups, according to research from a group at Hong Kong University.

Investigators from the University of Hong Kong say that the Lupus Low Disease Activity State (LLDAS) established in 2015 by the Asia-Pacific Lupus Collaboration1 can predict the risk of future lupus flare-ups, but there is no conclusive evidence yet that the low-disease state is associated with less damage and lower mortality rates. The results of a prospective study by Dr ALH Lee, from the department of medicine at Hong Kong University, and colleagues2 were presented at the 12th International Congress on SLE, March 26-20, in Melbourne, Australia.

LLDAS was achieved by 92.6% of patients during the study period, which included 62.1% of patient-days in LLDAS. No other demographic variables or previous disease presentations were associated with achieving LLDAS, the investigators asserted.

Study patients who achieved a higher percentage of days in LLDAS had a lower risk of lupus flare-ups (hazard ratio [HR] = 0.420, P =.015) after adjusting for gender and age. However, the data collected was insufficient to determine the effect of LLDAS on lupus-related damage and death.

“LLDAS is an independent construct achievable by most patients of different history or background,” the investigators wrote in their analysis. “Our preliminary study shows LLDAS can predict the risk of future flare-ups though further studies are needed to determine whether it is associated less lupus-related damage and lower mortality.”

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  1. Franklyn K, Lau CS, Navarra SV, et al, for the Asia-Pacific Lupus Collaboration. Definition and initial validation of a Lupus Low Disease Activity State (LLDAS). Ann Rheum Dis. 2016;75:1615-1621.
  2. Lee A, Cheung T, Chung H, et al. Validation of a novel definition of low disease activity state in systemic lupus erythematosus [published online March 24, 2017].  Lupus Sci  Med. doi:10.1136/lupus-2017-000215.12

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