SMART-SLE: Serology monitoring and repeat testing in systemic lupus erythematosus: An analysis of anti-double-stranded DNA monitoring
Objective Disease activity monitoring in SLE includes serial measurement of anti-double stranded-DNA (dsDNA) antibodies, but in patients who are persistently anti-dsDNA positive, the utility of repeated measurement is unclear. We investigated the usefulness of serial anti-dsDNA testing in predicting...
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my.um.eprints.460552024-07-16T07:28:01Z http://eprints.um.edu.my/46055/ SMART-SLE: Serology monitoring and repeat testing in systemic lupus erythematosus: An analysis of anti-double-stranded DNA monitoring Li Yeo, Ai Kandane-Rathnayake, Rangi Koelmeyer, Rachel Golder, Vera Louthrenoo, Worawit Chen, Yi-Hsing Cho, Jiacai Lateef, Aisha Hamijoyo, Laniyati Luo, Shue-Fen Wu, Yeong-Jian J. Navarra, Sandra Zamora, Leonid Li, Zhanguo An, Yuan Sockalingam, Sargunan Katsumata, Yasuhiro Harigai, Masayoshi Hao, Yanjie Zhang, Zhuoli Basnayake, B. M. D. B. Chan, Madelynn Kikuchi, Jun Takeuchi, Tsutomu Bae, Sang-Cheol Oon, Shereen O'Neill, Sean Goldblatt, Fiona Ng, Kristine (Pek Ling) Law, Annie Tugnet, Nicola Kumar, Sunil Tee, Cherica Tee, Michael Ohkubo, Naoaki Tanaka, Yoshiya Lau, Chak Sing Nikpour, Mandana Hoi, Alberta Leech, Michelle Morand, Eric F. Collaboration, Asia Pacific Lupus R Medicine Objective Disease activity monitoring in SLE includes serial measurement of anti-double stranded-DNA (dsDNA) antibodies, but in patients who are persistently anti-dsDNA positive, the utility of repeated measurement is unclear. We investigated the usefulness of serial anti-dsDNA testing in predicting flare in SLE patients who are persistently anti-dsDNA positive. Methods Data were analysed from patients in a multinational longitudinal cohort with known anti-dsDNA results from 2013 to 2021. Patients were categorized based on their anti-dsDNA results as persistently negative, fluctuating or persistently positive. Cox regression models were used to examine longitudinal associations of anti-dsDNA results with flare. Results Data from 37 582 visits of 3484 patients were analysed. Of the patients 1029 (29.5%) had persistently positive anti-dsDNA and 1195 (34.3%) had fluctuating results. Anti-dsDNA expressed as a ratio to the normal cut-off was associated with the risk of subsequent flare, including in the persistently positive cohort (adjusted hazard ratio HR] 1.56; 95% CI: 1.30, 1.87; P < 0.001) and fluctuating cohort (adjusted HR 1.46; 95% CI: 1.28, 1.66), both for a ratio >3. Both increases and decreases in anti-dsDNA more than 2-fold compared with the previous visit were associated with increased risk of flare in the fluctuating cohort (adjusted HR 1.33; 95% CI: 1.08, 1.65; P = 0.008) and the persistently positive cohort (adjusted HR 1.36; 95% CI: 1.08, 1.71; P = 0.009). Conclusion Absolute value and change in anti-dsDNA titres predict flares, including in persistently anti-dsDNA positive patients. This indicates that repeat monitoring of dsDNA has value in routine testing. Oxford Univ Press 2024-02 Article PeerReviewed Li Yeo, Ai and Kandane-Rathnayake, Rangi and Koelmeyer, Rachel and Golder, Vera and Louthrenoo, Worawit and Chen, Yi-Hsing and Cho, Jiacai and Lateef, Aisha and Hamijoyo, Laniyati and Luo, Shue-Fen and Wu, Yeong-Jian J. and Navarra, Sandra and Zamora, Leonid and Li, Zhanguo and An, Yuan and Sockalingam, Sargunan and Katsumata, Yasuhiro and Harigai, Masayoshi and Hao, Yanjie and Zhang, Zhuoli and Basnayake, B. M. D. B. and Chan, Madelynn and Kikuchi, Jun and Takeuchi, Tsutomu and Bae, Sang-Cheol and Oon, Shereen and O'Neill, Sean and Goldblatt, Fiona and Ng, Kristine (Pek Ling) and Law, Annie and Tugnet, Nicola and Kumar, Sunil and Tee, Cherica and Tee, Michael and Ohkubo, Naoaki and Tanaka, Yoshiya and Lau, Chak Sing and Nikpour, Mandana and Hoi, Alberta and Leech, Michelle and Morand, Eric F. and Collaboration, Asia Pacific Lupus (2024) SMART-SLE: Serology monitoring and repeat testing in systemic lupus erythematosus: An analysis of anti-double-stranded DNA monitoring. Rheumatology, 63 (2). pp. 525-533. ISSN 1462-0324, DOI https://doi.org/10.1093/rheumatology/kead231 <https://doi.org/10.1093/rheumatology/kead231>. 10.1093/rheumatology/kead231 |
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R Medicine Li Yeo, Ai Kandane-Rathnayake, Rangi Koelmeyer, Rachel Golder, Vera Louthrenoo, Worawit Chen, Yi-Hsing Cho, Jiacai Lateef, Aisha Hamijoyo, Laniyati Luo, Shue-Fen Wu, Yeong-Jian J. Navarra, Sandra Zamora, Leonid Li, Zhanguo An, Yuan Sockalingam, Sargunan Katsumata, Yasuhiro Harigai, Masayoshi Hao, Yanjie Zhang, Zhuoli Basnayake, B. M. D. B. Chan, Madelynn Kikuchi, Jun Takeuchi, Tsutomu Bae, Sang-Cheol Oon, Shereen O'Neill, Sean Goldblatt, Fiona Ng, Kristine (Pek Ling) Law, Annie Tugnet, Nicola Kumar, Sunil Tee, Cherica Tee, Michael Ohkubo, Naoaki Tanaka, Yoshiya Lau, Chak Sing Nikpour, Mandana Hoi, Alberta Leech, Michelle Morand, Eric F. Collaboration, Asia Pacific Lupus SMART-SLE: Serology monitoring and repeat testing in systemic lupus erythematosus: An analysis of anti-double-stranded DNA monitoring |
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Objective Disease activity monitoring in SLE includes serial measurement of anti-double stranded-DNA (dsDNA) antibodies, but in patients who are persistently anti-dsDNA positive, the utility of repeated measurement is unclear. We investigated the usefulness of serial anti-dsDNA testing in predicting flare in SLE patients who are persistently anti-dsDNA positive. Methods Data were analysed from patients in a multinational longitudinal cohort with known anti-dsDNA results from 2013 to 2021. Patients were categorized based on their anti-dsDNA results as persistently negative, fluctuating or persistently positive. Cox regression models were used to examine longitudinal associations of anti-dsDNA results with flare. Results Data from 37 582 visits of 3484 patients were analysed. Of the patients 1029 (29.5%) had persistently positive anti-dsDNA and 1195 (34.3%) had fluctuating results. Anti-dsDNA expressed as a ratio to the normal cut-off was associated with the risk of subsequent flare, including in the persistently positive cohort (adjusted hazard ratio HR] 1.56; 95% CI: 1.30, 1.87; P < 0.001) and fluctuating cohort (adjusted HR 1.46; 95% CI: 1.28, 1.66), both for a ratio >3. Both increases and decreases in anti-dsDNA more than 2-fold compared with the previous visit were associated with increased risk of flare in the fluctuating cohort (adjusted HR 1.33; 95% CI: 1.08, 1.65; P = 0.008) and the persistently positive cohort (adjusted HR 1.36; 95% CI: 1.08, 1.71; P = 0.009). Conclusion Absolute value and change in anti-dsDNA titres predict flares, including in persistently anti-dsDNA positive patients. This indicates that repeat monitoring of dsDNA has value in routine testing. |
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Li Yeo, Ai Kandane-Rathnayake, Rangi Koelmeyer, Rachel Golder, Vera Louthrenoo, Worawit Chen, Yi-Hsing Cho, Jiacai Lateef, Aisha Hamijoyo, Laniyati Luo, Shue-Fen Wu, Yeong-Jian J. Navarra, Sandra Zamora, Leonid Li, Zhanguo An, Yuan Sockalingam, Sargunan Katsumata, Yasuhiro Harigai, Masayoshi Hao, Yanjie Zhang, Zhuoli Basnayake, B. M. D. B. Chan, Madelynn Kikuchi, Jun Takeuchi, Tsutomu Bae, Sang-Cheol Oon, Shereen O'Neill, Sean Goldblatt, Fiona Ng, Kristine (Pek Ling) Law, Annie Tugnet, Nicola Kumar, Sunil Tee, Cherica Tee, Michael Ohkubo, Naoaki Tanaka, Yoshiya Lau, Chak Sing Nikpour, Mandana Hoi, Alberta Leech, Michelle Morand, Eric F. Collaboration, Asia Pacific Lupus |
author_facet |
Li Yeo, Ai Kandane-Rathnayake, Rangi Koelmeyer, Rachel Golder, Vera Louthrenoo, Worawit Chen, Yi-Hsing Cho, Jiacai Lateef, Aisha Hamijoyo, Laniyati Luo, Shue-Fen Wu, Yeong-Jian J. Navarra, Sandra Zamora, Leonid Li, Zhanguo An, Yuan Sockalingam, Sargunan Katsumata, Yasuhiro Harigai, Masayoshi Hao, Yanjie Zhang, Zhuoli Basnayake, B. M. D. B. Chan, Madelynn Kikuchi, Jun Takeuchi, Tsutomu Bae, Sang-Cheol Oon, Shereen O'Neill, Sean Goldblatt, Fiona Ng, Kristine (Pek Ling) Law, Annie Tugnet, Nicola Kumar, Sunil Tee, Cherica Tee, Michael Ohkubo, Naoaki Tanaka, Yoshiya Lau, Chak Sing Nikpour, Mandana Hoi, Alberta Leech, Michelle Morand, Eric F. Collaboration, Asia Pacific Lupus |
author_sort |
Li Yeo, Ai |
title |
SMART-SLE: Serology monitoring and repeat testing in systemic lupus erythematosus: An analysis of anti-double-stranded DNA monitoring |
title_short |
SMART-SLE: Serology monitoring and repeat testing in systemic lupus erythematosus: An analysis of anti-double-stranded DNA monitoring |
title_full |
SMART-SLE: Serology monitoring and repeat testing in systemic lupus erythematosus: An analysis of anti-double-stranded DNA monitoring |
title_fullStr |
SMART-SLE: Serology monitoring and repeat testing in systemic lupus erythematosus: An analysis of anti-double-stranded DNA monitoring |
title_full_unstemmed |
SMART-SLE: Serology monitoring and repeat testing in systemic lupus erythematosus: An analysis of anti-double-stranded DNA monitoring |
title_sort |
smart-sle: serology monitoring and repeat testing in systemic lupus erythematosus: an analysis of anti-double-stranded dna monitoring |
publisher |
Oxford Univ Press |
publishDate |
2024 |
url |
http://eprints.um.edu.my/46055/ |
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1805881183398002688 |
score |
13.209306 |