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Prevalence of flare and influence of demographic and serologic factors on flare risk in systemic lupus erythematosus: A prospective study
Journal of Rheumatology, 10/20/09
Petri M et al. – The organ system distribution of A and B flares is very different, with A flares more common in renal and mucocutaneous, and B flares more common in hematologic and renal systems. A or 2B flares are significantly more common in African Americans and in patients with abnormal serologies (low C3, low C4, or high anti-dsDNA). If flare is an outcome in an SLE clinical trial, these factors must be balanced by taking them into account at baseline in terms of randomization, or by statistical adjustment in final analyses.
Methods- 299 patients
- Followed for 1 y with BILAG scores calculated using British Lupus Integrated Prospective System software
- “A” flares occurred at rate of 0.254/year, “B” flares 1.637/year, and A or B flares 1.765/year
- Risk factors for later A or B flare in hematological system included: low C3 , low C4 , and positive antidouble-stranded (ds)DNA ; in the mucocutaneous system: low C3 and low C4 ; and in the renal system: low C3 and low C4
- In stepwise regression model, only ethnicity and low C4 remained as independent predictors of later A or 2B flares
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