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Immunology - Public Health and Epidemiology - Rheumatology

Flare, Persistently Active Disease, and Serologically Active Clinically Quiescent Disease in Systemic Lupus Erythematosus: A 2-Year Follow-Up Study
Published: Friday, September 21, 2012
Author: Fabrizio Conti et al.

by Fabrizio Conti, Fulvia Ceccarelli, Carlo Perricone, Francesca Miranda, Simona Truglia, Laura Massaro, Viviana Antonella Pacucci, Virginia Conti, Izabella Bartosiewicz, Francesca Romana Spinelli, Cristiano Alessandri, Guido Valesini


Several indices have been proposed to assess disease activity in patients with Systemic Lupus Erythematosus (SLE). Recent studies have showed a prevalence of flare between 28–35.3%, persistently active disease (PAD) between 46%–52% and serologically active clinically quiescent (SACQ) disease ranging from 6 to 15%. Our goal was to evaluate the flare, PAD and SACQ rate incidence in a cohort of SLE patients over a 2-year follow-up.


We evaluated 394 SLE patients. Flare was defined as an increase in SLEDAI-2K score of =4 from the previous visit; PAD was defined as a SLEDAI-2K score of =4, on >2 consecutive visits; SACQ was defined as at least a 2-year period without clinical activity and with persistent serologic activity.


Among the 95 patients eligible for the analysis in 2009, 7 (7.3%) had =1 flare episode, whereas 9 (9.4%) had PAD. Similarly, among the 118 patients selected for the analysis in 2010, 6 (5%) had =1 flare episode, whereas 16 (13.5%) had PAD. Only 1/45 patient (2.2%) showed SACQ during the follow-up.


We showed a low incidence of flare, PAD and SACQ in Italian SLE patients compared with previous studies which could be partly explained by ethnic differences.