Recent data suggest that the prevalence of physician-diagnosed systemic lupus erythematosus (SLE) is 6-10 fold greater than previous reports. SLE, which affects primarily young women in the prime of life, leads to increased mortality, chronic organ system damage, and a poor health status equivalent to that in HIV infection. The Baltimore Lupus Cohort is an ongoing, prospective study in which SLE patients are followed, by protocol, quarterly. It is racially balanced and reflects a wide socioeconomic range. Building on this 8 year database of demographic, social, clinical and laboratory measures, the current proposal will address three new areas. First, we will determine the predictive value for lupus activity/flare (using valid and reliable disease activity indices) of currently available serologic tests (C3, C4 anti-dsDNA by two assays) and investigational assays (complement split products) in longitudinal regression models that adjust for demographic, clinical, and treatment variables. Second, we will accrue sufficient outcomes to identify prospective risk factors for permanent organ damage, which often does not appear (as in the case of renal damage) for 10 years after diagnosis. This will include an assessment of markers of on-going coagulation to determine if these are predictors of those SLE patients with antiphospholipid antibodies at risk for thrombosis. To increase the power in analyses of risk factors for atherosclerosis, a surrogate outcome variable, carotid duplex, will be added. Finally, we will prospectively determine the predictors of health status and change in health status (emphasizing disease activity, organ damage, treatment variables, psychological constructs such as coping skills, and serial assessment of fibromyalgia). Understanding the basis of change in health status measures is necessary to justify the future use of these measures as efficacy outcomes in clinical trials.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR043727-03
Application #
2899898
Study Section
Special Emphasis Panel (ZRG4-EDC-1 (03))
Program Officer
Serrate-Sztein, Susana
Project Start
1996-09-30
Project End
2001-03-31
Budget Start
1999-04-01
Budget End
2000-03-31
Support Year
3
Fiscal Year
1999
Total Cost
Indirect Cost
Name
Johns Hopkins University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
045911138
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Little, Jayne; Parker, Ben; Lunt, Mark et al. (2018) Glucocorticoid use and factors associated with variability in this use in the Systemic Lupus International Collaborating Clinics Inception Cohort. Rheumatology (Oxford) 57:677-687
Iftikhar, Mustafa; Kaur, Ramandeep; Nefalar, April et al. (2018) MICROPERIMETRY AS A SCREENING TEST FOR HYDROXYCHLOROQUINE RETINOPATHY: The Hard-Risk-1 Study. Retina :
Merrill, Joan T; Petri, Michelle A; Buyon, Jill et al. (2018) Erythrocyte-bound C4d in combination with complement and autoantibody status for the monitoring of SLE. Lupus Sci Med 5:e000263
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Davidson, Julie E; Fu, Qinggong; Ji, Beulah et al. (2018) Renal Remission Status and Longterm Renal Survival in Patients with Lupus Nephritis: A Retrospective Cohort Analysis. J Rheumatol 45:671-677
Bernatsky, Sasha; Ramsey-Goldman, Rosalind; Petri, Michelle et al. (2018) Smoking Is the Most Significant Modifiable Lung Cancer Risk Factor in Systemic Lupus Erythematosus. J Rheumatol 45:393-396
Costedoat-Chalumeau, Nathalie; Houssiau, Frédéric; Izmirly, Peter et al. (2018) A Prospective International Study on Adherence to Treatment in 305 Patients With Flaring SLE: Assessment by Drug Levels and Self-Administered Questionnaires. Clin Pharmacol Ther 103:1074-1082
Giannakou, Ioanna; Chatzidionysiou, Katerina; Magder, Laurence S et al. (2018) Predictors of persistent disease activity and long quiescence in systemic lupus erythematosus: results from the Hopkins Lupus Cohort. Lupus Sci Med 5:e000287
Patel, Zubin; Lu, Xiaoming; Miller, Daniel et al. (2018) A plausibly causal functional lupus-associated risk variant in the STAT1-STAT4 locus. Hum Mol Genet :
Putterman, Chaim; Pisetsky, David S; Petri, Michelle et al. (2018) The SLE-key test serological signature: new insights into the course of lupus. Rheumatology (Oxford) 57:1632-1640

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