The BILAG-2004 index is associated with development of new damage in SLE

Chee-Seng Yee; Caroline Gordon; Akil Mohammed; Peter Lanyon; Christopher J. Edwards; David Isenberg; Anisur Rahman; Lee-Suan Teh; Sofia Tosounidou; Robert Stevens; Athiveeraramapandian Prabu; Bridget Griffiths; Neil McHugh; Ian N Bruce; Yasmeen Ahmad; Munther A Khamashta; Vernon T Farewell

doi:10.1093/rheumatology/keac334

The BILAG-2004 index is associated with development of new damage in SLE

Chee-Seng Yee, Caroline Gordon, Akil Mohammed, Peter Lanyon, Christopher J. Edwards, David Isenberg, Anisur Rahman, Lee-Suan Teh, Sofia Tosounidou, Robert Stevens, Athiveeraramapandian Prabu, Bridget Griffiths, Neil McHugh, Ian N Bruce, Yasmeen Ahmad, Munther A Khamashta, Vernon T Farewell

Inflammation and Ageing

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Abstract

Objective: To determine if BILAG-2004 index is associated with the development of damage in a cohort of SLE patients. Mortality and development of damage were examined.

Methods: This was a multi-centre longitudinal study. Patients were recruited within 12 months of achieving 4th ACR classification criterion for SLE. Data were collected on disease activity, damage, SLE-specific drug exposure, cardiovascular risk factors, antiphospholipid syndrome status and death at every visit. This study ran from 1st January 2005 to 31st December 2017. Descriptive statistics were used to analyse mortality and development of new damage. Poisson regression was used to examine potential explanatory variables for development of new damage.

Results: 273 SLE patients were recruited with total follow-up of 1767 patient-years (median 73.4 months). There were 6348 assessments with disease activity scores available for analysis. During follow-up, 13 deaths and 144 new damage items (in 83 patients) occurs. The incidence rate for development of damage was higher in the first 3 years before stabilising at a lower rate. Overall rate for damage accrual was 61.1 per 1000 person-years (95% CI:50.6, 73.8). Analysis showed that active disease scores according to BILAD-2004 index (systems scores of A or B, counts of systems with A and BILAG-2004 numerical score) were associated with development of new damage. Low disease activity (LDA) states (BILAG-2004 LDA and BILAG Systems Tally (BST) persistent LDA) were inversely associated with development of damage.

Conclusions: BILAG-2004 index is associated with new damage. BILAG-2044 LDA and BST persistent LDA can be considered as treatment targets.

Original language	English
Article number	keac334
Journal	Rheumatology (Oxford, England)
Early online date	10 Jun 2022
DOIs	https://doi.org/10.1093/rheumatology/keac334
Publication status	E-pub ahead of print - 10 Jun 2022

Keywords

BILAG-2004
SLE
disease activity
damage
mortality

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10.1093/rheumatology/keac334

YeeC2022BILAG2004
This is a pre-copyedited, author-produced version of an article accepted for publication in Rheumatology following peer review. The version of record Chee-Seng Yee, Caroline Gordon, Mohammed Akil, Peter Lanyon, Christopher J Edwards, David A Isenberg, Anisur Rahman, Lee-Suan Teh, Sofia Tosounidou, Robert Stevens, Athiveeraramapandian Prabu, Bridget Griffiths, Neil McHugh, Ian N Bruce, Yasmeen Ahmad, Munther A Khamashta, Vernon T Farewell, The BILAG-2004 index is associated with development of new damage in SLE, Rheumatology, 2022, keac334 is available online at: https://doi.org/10.1093/rheumatology/keac334
Accepted author manuscript, 5.56 MBLicence: None: All rights reserved

Cite this

Yee, C.-S., Gordon, C., Mohammed, A., Lanyon, P., Edwards, C. J., Isenberg, D., Rahman, A., Teh, L.-S., Tosounidou, S., Stevens, R., Prabu, A., Griffiths, B., McHugh, N., Bruce, I. N., Ahmad, Y., Khamashta, M. A., & Farewell, V. T. (2022). The BILAG-2004 index is associated with development of new damage in SLE. Rheumatology (Oxford, England), Article keac334. Advance online publication. https://doi.org/10.1093/rheumatology/keac334

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title = "The BILAG-2004 index is associated with development of new damage in SLE",

abstract = "Objective: To determine if BILAG-2004 index is associated with the development of damage in a cohort of SLE patients. Mortality and development of damage were examined.Methods: This was a multi-centre longitudinal study. Patients were recruited within 12 months of achieving 4th ACR classification criterion for SLE. Data were collected on disease activity, damage, SLE-specific drug exposure, cardiovascular risk factors, antiphospholipid syndrome status and death at every visit. This study ran from 1st January 2005 to 31st December 2017. Descriptive statistics were used to analyse mortality and development of new damage. Poisson regression was used to examine potential explanatory variables for development of new damage.Results: 273 SLE patients were recruited with total follow-up of 1767 patient-years (median 73.4 months). There were 6348 assessments with disease activity scores available for analysis. During follow-up, 13 deaths and 144 new damage items (in 83 patients) occurs. The incidence rate for development of damage was higher in the first 3 years before stabilising at a lower rate. Overall rate for damage accrual was 61.1 per 1000 person-years (95% CI:50.6, 73.8). Analysis showed that active disease scores according to BILAD-2004 index (systems scores of A or B, counts of systems with A and BILAG-2004 numerical score) were associated with development of new damage. Low disease activity (LDA) states (BILAG-2004 LDA and BILAG Systems Tally (BST) persistent LDA) were inversely associated with development of damage.Conclusions: BILAG-2004 index is associated with new damage. BILAG-2044 LDA and BST persistent LDA can be considered as treatment targets.",

keywords = "BILAG-2004, SLE, disease activity, damage, mortality",

author = "Chee-Seng Yee and Caroline Gordon and Akil Mohammed and Peter Lanyon and Edwards, {Christopher J.} and David Isenberg and Anisur Rahman and Lee-Suan Teh and Sofia Tosounidou and Robert Stevens and Athiveeraramapandian Prabu and Bridget Griffiths and Neil McHugh and Bruce, {Ian N} and Yasmeen Ahmad and Khamashta, {Munther A} and Farewell, {Vernon T}",

year = "2022",

month = jun,

day = "10",

doi = "10.1093/rheumatology/keac334",

language = "English",

journal = "Rheumatology (Oxford, England)",

issn = "1462-0324",

publisher = "Oxford University Press",

}

TY - JOUR

T1 - The BILAG-2004 index is associated with development of new damage in SLE

AU - Yee, Chee-Seng

AU - Gordon, Caroline

AU - Mohammed, Akil

AU - Lanyon, Peter

AU - Edwards, Christopher J.

AU - Isenberg, David

AU - Rahman, Anisur

AU - Teh, Lee-Suan

AU - Tosounidou, Sofia

AU - Stevens, Robert

AU - Prabu, Athiveeraramapandian

AU - Griffiths, Bridget

AU - McHugh, Neil

AU - Bruce, Ian N

AU - Ahmad, Yasmeen

AU - Khamashta, Munther A

AU - Farewell, Vernon T

PY - 2022/6/10

Y1 - 2022/6/10

N2 - Objective: To determine if BILAG-2004 index is associated with the development of damage in a cohort of SLE patients. Mortality and development of damage were examined.Methods: This was a multi-centre longitudinal study. Patients were recruited within 12 months of achieving 4th ACR classification criterion for SLE. Data were collected on disease activity, damage, SLE-specific drug exposure, cardiovascular risk factors, antiphospholipid syndrome status and death at every visit. This study ran from 1st January 2005 to 31st December 2017. Descriptive statistics were used to analyse mortality and development of new damage. Poisson regression was used to examine potential explanatory variables for development of new damage.Results: 273 SLE patients were recruited with total follow-up of 1767 patient-years (median 73.4 months). There were 6348 assessments with disease activity scores available for analysis. During follow-up, 13 deaths and 144 new damage items (in 83 patients) occurs. The incidence rate for development of damage was higher in the first 3 years before stabilising at a lower rate. Overall rate for damage accrual was 61.1 per 1000 person-years (95% CI:50.6, 73.8). Analysis showed that active disease scores according to BILAD-2004 index (systems scores of A or B, counts of systems with A and BILAG-2004 numerical score) were associated with development of new damage. Low disease activity (LDA) states (BILAG-2004 LDA and BILAG Systems Tally (BST) persistent LDA) were inversely associated with development of damage.Conclusions: BILAG-2004 index is associated with new damage. BILAG-2044 LDA and BST persistent LDA can be considered as treatment targets.

AB - Objective: To determine if BILAG-2004 index is associated with the development of damage in a cohort of SLE patients. Mortality and development of damage were examined.Methods: This was a multi-centre longitudinal study. Patients were recruited within 12 months of achieving 4th ACR classification criterion for SLE. Data were collected on disease activity, damage, SLE-specific drug exposure, cardiovascular risk factors, antiphospholipid syndrome status and death at every visit. This study ran from 1st January 2005 to 31st December 2017. Descriptive statistics were used to analyse mortality and development of new damage. Poisson regression was used to examine potential explanatory variables for development of new damage.Results: 273 SLE patients were recruited with total follow-up of 1767 patient-years (median 73.4 months). There were 6348 assessments with disease activity scores available for analysis. During follow-up, 13 deaths and 144 new damage items (in 83 patients) occurs. The incidence rate for development of damage was higher in the first 3 years before stabilising at a lower rate. Overall rate for damage accrual was 61.1 per 1000 person-years (95% CI:50.6, 73.8). Analysis showed that active disease scores according to BILAD-2004 index (systems scores of A or B, counts of systems with A and BILAG-2004 numerical score) were associated with development of new damage. Low disease activity (LDA) states (BILAG-2004 LDA and BILAG Systems Tally (BST) persistent LDA) were inversely associated with development of damage.Conclusions: BILAG-2004 index is associated with new damage. BILAG-2044 LDA and BST persistent LDA can be considered as treatment targets.

KW - BILAG-2004

KW - SLE

KW - disease activity

KW - damage

KW - mortality

U2 - 10.1093/rheumatology/keac334

DO - 10.1093/rheumatology/keac334

M3 - Article

SN - 1462-0324

JO - Rheumatology (Oxford, England)

JF - Rheumatology (Oxford, England)

M1 - keac334

ER -

The BILAG-2004 index is associated with development of new damage in SLE

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Keywords

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