Predictors of persistent disease activity and long quiescence in systemic lupus erythematosus: Results from the Hopkins Lupus Cohort

Objectives The aim of this study is to identify prognostic factors of persistent disease activity and long quiescence in systemic lupus erythematosus (SLE). Methods Patients enrolled in the Hopkins Lupus Cohort from 1987 to 2012, who attended at least three visits per year during 3 consecutive years following baseline and had available information on disease activity were included. Patterns of SLE disease activity over the 3-year period were defined as: persistent long quiescent (pLQ), persistent relapsing-remitting (pRR), persistent chronic active (pCA) and mixed based on Modified SLE Disease Activity Index (M-SLEDAI). Possible predictors of pCA (vs pLQ, pRR and mixed) and pLQ (vs pCA, pRR and mixed) were identified by univariate and multivariate logistic regression analyses. Results 916 patients were included. In the multivariate analysis, use of hydroxychloroquine (OR: 0.45, 95%CI 0.22 to 0.92, p=0.03), African American ethnicity (OR: 2.36, 95%CI 1.15 to 4.85, p=0.02) and baseline SLEDAI (OR: 1.10, 95%CI 1.03 to 1.17, p=0.005) remained significant predictors of pCA. Higher education (>12 years; OR. 2.07, 95%CI 1.07 to 4.03, p=0.03) and lower baseline SLEDAI (OR: 0.67, 95%CI 0.56 to 0.82, p<0.001) were significant predictors of pLQ, while African American (OR: 0.38, 95%CI 0.17 to 0.83, p=0.02) and female patients (OR: 0.26, 95%CI 0.12 to 0.57, p