Siobhan Case, C Larry Hill, Peter Shrader, Anne Dennos, Thomas Phillips, Laura Eve Schanberg, Emily von Scheven, Kamil Barbour, Andrea M Knight, Aimee Hersh, MaryBeth Son
{"title":"儿童狼疮的疾病活动轨迹及其与社会经济因素和患者报告的疼痛的关联。","authors":"Siobhan Case, C Larry Hill, Peter Shrader, Anne Dennos, Thomas Phillips, Laura Eve Schanberg, Emily von Scheven, Kamil Barbour, Andrea M Knight, Aimee Hersh, MaryBeth Son","doi":"10.1136/lupus-2025-001521","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Using data from participants with paediatric SLE (pSLE) in the Childhood Arthritis and Rheumatology Research Alliance Registry, we aimed to: (1) describe 2-year disease activity trajectories, measured by the SLE Disease Activity Index 2000 (SLEDAI 2K); (2) identify characteristics associated with each trajectory and (3) assess achievement of lupus low disease activity state (LLDAS) and associated baseline characteristics.</p><p><strong>Methods: </strong>Participants were diagnosed with pSLE within 12 months of baseline visit. Baseline sociodemographic, clinical and treatment characteristics were included in latent trajectory analyses. Associations between patient characteristics with trajectory groups and LLDAS were analysed with multinomial generalised logistic regression modelling.</p><p><strong>Results: </strong>1002 patients were screened; 553 were included for SLEDAI 2K and 269 for LLDAS analyses. SLEDAI 2K trajectories included (T1) low and stable, (T2) high and decreasing, (T3) intermediate and stable. In multinomial generalised logistic regression, baseline SLEDAI 2K score and insurance type were significantly associated with trajectories. 51% (136/269) of patients achieved LLDAS at least once in 24 months as compared with 17% (47/269) at first assessment. LLDAS attainment at both time points was predicted by lower pain interference scores; LLDAS attainment over 24 months was also associated with baseline American College of Rheumatology classification criteria, rituximab use at baseline and highest completed level of parent/guardian education.</p><p><strong>Conclusions: </strong>Disease activity trajectories in a pSLE cohort were predicted by baseline SLEDAI 2K and insurance. Only half of the patients achieved LLDAS during the 2-year study period, which was predicted by baseline characteristics including pain interference. The relationship between disease activity and socioeconomic factors and pain warrants further investigation to identify modifiable factors to reduce pSLE disease activity.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352166/pdf/","citationCount":"0","resultStr":"{\"title\":\"Disease activity trajectories in paediatric lupus and associations with socioeconomic factors and patient-reported pain.\",\"authors\":\"Siobhan Case, C Larry Hill, Peter Shrader, Anne Dennos, Thomas Phillips, Laura Eve Schanberg, Emily von Scheven, Kamil Barbour, Andrea M Knight, Aimee Hersh, MaryBeth Son\",\"doi\":\"10.1136/lupus-2025-001521\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Using data from participants with paediatric SLE (pSLE) in the Childhood Arthritis and Rheumatology Research Alliance Registry, we aimed to: (1) describe 2-year disease activity trajectories, measured by the SLE Disease Activity Index 2000 (SLEDAI 2K); (2) identify characteristics associated with each trajectory and (3) assess achievement of lupus low disease activity state (LLDAS) and associated baseline characteristics.</p><p><strong>Methods: </strong>Participants were diagnosed with pSLE within 12 months of baseline visit. Baseline sociodemographic, clinical and treatment characteristics were included in latent trajectory analyses. Associations between patient characteristics with trajectory groups and LLDAS were analysed with multinomial generalised logistic regression modelling.</p><p><strong>Results: </strong>1002 patients were screened; 553 were included for SLEDAI 2K and 269 for LLDAS analyses. SLEDAI 2K trajectories included (T1) low and stable, (T2) high and decreasing, (T3) intermediate and stable. In multinomial generalised logistic regression, baseline SLEDAI 2K score and insurance type were significantly associated with trajectories. 51% (136/269) of patients achieved LLDAS at least once in 24 months as compared with 17% (47/269) at first assessment. LLDAS attainment at both time points was predicted by lower pain interference scores; LLDAS attainment over 24 months was also associated with baseline American College of Rheumatology classification criteria, rituximab use at baseline and highest completed level of parent/guardian education.</p><p><strong>Conclusions: </strong>Disease activity trajectories in a pSLE cohort were predicted by baseline SLEDAI 2K and insurance. Only half of the patients achieved LLDAS during the 2-year study period, which was predicted by baseline characteristics including pain interference. The relationship between disease activity and socioeconomic factors and pain warrants further investigation to identify modifiable factors to reduce pSLE disease activity.</p>\",\"PeriodicalId\":18126,\"journal\":{\"name\":\"Lupus Science & Medicine\",\"volume\":\"12 2\",\"pages\":\"\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-08-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352166/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Lupus Science & Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/lupus-2025-001521\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lupus Science & Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/lupus-2025-001521","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
Disease activity trajectories in paediatric lupus and associations with socioeconomic factors and patient-reported pain.
Objective: Using data from participants with paediatric SLE (pSLE) in the Childhood Arthritis and Rheumatology Research Alliance Registry, we aimed to: (1) describe 2-year disease activity trajectories, measured by the SLE Disease Activity Index 2000 (SLEDAI 2K); (2) identify characteristics associated with each trajectory and (3) assess achievement of lupus low disease activity state (LLDAS) and associated baseline characteristics.
Methods: Participants were diagnosed with pSLE within 12 months of baseline visit. Baseline sociodemographic, clinical and treatment characteristics were included in latent trajectory analyses. Associations between patient characteristics with trajectory groups and LLDAS were analysed with multinomial generalised logistic regression modelling.
Results: 1002 patients were screened; 553 were included for SLEDAI 2K and 269 for LLDAS analyses. SLEDAI 2K trajectories included (T1) low and stable, (T2) high and decreasing, (T3) intermediate and stable. In multinomial generalised logistic regression, baseline SLEDAI 2K score and insurance type were significantly associated with trajectories. 51% (136/269) of patients achieved LLDAS at least once in 24 months as compared with 17% (47/269) at first assessment. LLDAS attainment at both time points was predicted by lower pain interference scores; LLDAS attainment over 24 months was also associated with baseline American College of Rheumatology classification criteria, rituximab use at baseline and highest completed level of parent/guardian education.
Conclusions: Disease activity trajectories in a pSLE cohort were predicted by baseline SLEDAI 2K and insurance. Only half of the patients achieved LLDAS during the 2-year study period, which was predicted by baseline characteristics including pain interference. The relationship between disease activity and socioeconomic factors and pain warrants further investigation to identify modifiable factors to reduce pSLE disease activity.
期刊介绍：
Lupus Science & Medicine is a global, peer reviewed, open access online journal that provides a central point for publication of basic, clinical, translational, and epidemiological studies of all aspects of lupus and related diseases. It is the first lupus-specific open access journal in the world and was developed in response to the need for a barrier-free forum for publication of groundbreaking studies in lupus. The journal publishes research on lupus from fields including, but not limited to: rheumatology, dermatology, nephrology, immunology, pediatrics, cardiology, hepatology, pulmonology, obstetrics and gynecology, and psychiatry.
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