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Abstract：
OBJECTIVE: To investigate the rates of low disease activity and clinical remission in patients with systemic lupus erythematosus (SLE) in a real-world setting, and to analyze the related factors of low disease activity and clinical remission.
METHODS: One thousand patients with SLE were enrolled from 11 teaching hospitals. Demographic, clinical and laboratory data, as well as treatment regimes were collec-ted by self-completed questionnaire. The rates of low disease activity and remission were calculated based on the lupus low disease activity state (LLDAS) and definitions of remission in SLE (DORIS). Charac-teristics of patients with LLDAS and DORIS were analyzed. Multivariate Logistic regression analysis was used to evaluate the related factors of LLDAS and DORIS remission.
RESULTS: 20.7% of patients met the criteria of LLDAS, while 10.4% of patients achieved remission defined by DORIS. Patients who met LLDAS or DORIS remission had significantly higher proportion of patients with high income and longer disease duration, compared with non-remission group. Moreover, the rates of anemia, creatinine elevation, increased erythrocyte sedimentation rate (ESR) and hypoalbuminemia was significantly lower in the LLDAS or DORIS group than in the non-remission group. Patients who received hydroxychloroquine for more than 12 months or immunosuppressant therapy for no less than 6 months earned higher rates of LLDAS and DORIS remission. The results of Logistic regression analysis showed that increased ESR, positive anti-dsDNA antibodies, low level of complement (C3 and C4), proteinuria, low household income were negatively related with LLDAS and DORIS remission. However, hydroxychloroquine usage for longer than 12 months were positively related with LLDAS and DORIS remission.
CONCLUSIONS: LLDAS and DORIS remission of SLE patients remain to be improved. Treatment-to-target strategy and standar-dized application of hydroxychloroquine and immunosuppressants in SLE are recommended.
METHODS: One thousand patients with SLE were enrolled from 11 teaching hospitals. Demographic, clinical and laboratory data, as well as treatment regimes were collec-ted by self-completed questionnaire. The rates of low disease activity and remission were calculated based on the lupus low disease activity state (LLDAS) and definitions of remission in SLE (DORIS). Charac-teristics of patients with LLDAS and DORIS were analyzed. Multivariate Logistic regression analysis was used to evaluate the related factors of LLDAS and DORIS remission.
RESULTS: 20.7% of patients met the criteria of LLDAS, while 10.4% of patients achieved remission defined by DORIS. Patients who met LLDAS or DORIS remission had significantly higher proportion of patients with high income and longer disease duration, compared with non-remission group. Moreover, the rates of anemia, creatinine elevation, increased erythrocyte sedimentation rate (ESR) and hypoalbuminemia was significantly lower in the LLDAS or DORIS group than in the non-remission group. Patients who received hydroxychloroquine for more than 12 months or immunosuppressant therapy for no less than 6 months earned higher rates of LLDAS and DORIS remission. The results of Logistic regression analysis showed that increased ESR, positive anti-dsDNA antibodies, low level of complement (C3 and C4), proteinuria, low household income were negatively related with LLDAS and DORIS remission. However, hydroxychloroquine usage for longer than 12 months were positively related with LLDAS and DORIS remission.
CONCLUSIONS: LLDAS and DORIS remission of SLE patients remain to be improved. Treatment-to-target strategy and standar-dized application of hydroxychloroquine and immunosuppressants in SLE are recommended.
摘要：
目的：调查真实世界中系统性红斑狼疮（SLE）患者的低疾病活动性和临床缓解率，并分析疾病活动度低和临床缓解的相关因素。
方法：从11家教学医院招募1000名SLE患者。人口统计,临床和实验室数据，以及治疗方案由自填问卷收集。根据狼疮低疾病活动度状态（LLDAS）和SLE缓解（DORIS）的定义计算低疾病活动度和缓解率。分析LLDAS和DORIS患者的特点。采用多因素Logistic回归分析评价LLDAS和DORIS缓解的相关因素。
结果：20.7%的患者符合LLDAS标准，而10.4%的患者达到了DORIS定义的缓解。符合LLDAS或DORIS缓解的患者在高收入和疾病持续时间较长的患者中比例明显更高。与非缓解组相比。此外，贫血的发生率，肌酐升高,LLDAS或DORIS组的红细胞沉降率(ESR)升高和低蛋白血症显著低于非缓解组.接受羟氯喹超过12个月或免疫抑制剂治疗不少于6个月的患者获得了更高的LLDAS和DORIS缓解率。Logistic回归分析结果表明,ESR升高,抗dsDNA抗体阳性，补体水平低（C3和C4），蛋白尿,低家庭收入与LLDAS和DORIS缓解呈负相关。然而,使用羟氯喹超过12个月与LLDAS和DORIS缓解呈正相关。
结论：SLE患者的LLDAS和DORIS缓解仍有待改善。建议在SLE中采用靶向治疗策略和标准化应用羟氯喹和免疫抑制剂。
方法：从11家教学医院招募1000名SLE患者。人口统计,临床和实验室数据，以及治疗方案由自填问卷收集。根据狼疮低疾病活动度状态（LLDAS）和SLE缓解（DORIS）的定义计算低疾病活动度和缓解率。分析LLDAS和DORIS患者的特点。采用多因素Logistic回归分析评价LLDAS和DORIS缓解的相关因素。
结果：20.7%的患者符合LLDAS标准，而10.4%的患者达到了DORIS定义的缓解。符合LLDAS或DORIS缓解的患者在高收入和疾病持续时间较长的患者中比例明显更高。与非缓解组相比。此外，贫血的发生率，肌酐升高,LLDAS或DORIS组的红细胞沉降率(ESR)升高和低蛋白血症显著低于非缓解组.接受羟氯喹超过12个月或免疫抑制剂治疗不少于6个月的患者获得了更高的LLDAS和DORIS缓解率。Logistic回归分析结果表明,ESR升高,抗dsDNA抗体阳性，补体水平低（C3和C4），蛋白尿,低家庭收入与LLDAS和DORIS缓解呈负相关。然而,使用羟氯喹超过12个月与LLDAS和DORIS缓解呈正相关。
结论：SLE患者的LLDAS和DORIS缓解仍有待改善。建议在SLE中采用靶向治疗策略和标准化应用羟氯喹和免疫抑制剂。
