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.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG4-EDC-1 (03))
Program Officer
Serrate-Sztein, Susana
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Johns Hopkins University
Internal Medicine/Medicine
Schools of Medicine
United States
Zip Code
Zhang, Zhe; Shi, Lihua; Song, Li et al. (2018) Overall Downregulation of mRNAs and Enrichment of H3K4me3 Change Near Genome-Wide Association Study Signals in Systemic Lupus Erythematosus: Cell-Specific Effects. Front Immunol 9:497
Shi, Lihua; Li, Song; Maurer, Kelly et al. (2018) Enhancer RNA and NF?B-dependent P300 regulation of ADAMDEC1. Mol Immunol 103:312-321
Ng, X; dosReis, S; Beardsley, R et al. (2018) Understanding systemic lupus erythematosus patients' desired outcomes and their perceptions of the risks and benefits of using corticosteroids. Lupus 27:475-483
Hanly, John G; Li, Qiuju; Su, Li et al. (2018) Cerebrovascular Events in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study. Arthritis Care Res (Hoboken) 70:1478-1487
Barber, Megan R W; Hanly, John G; Su, Li et al. (2018) Economic Evaluation of Lupus Nephritis in the Systemic Lupus International Collaborating Clinics Inception Cohort Using a Multistate Model Approach. Arthritis Care Res (Hoboken) 70:1294-1302
Davidson, Julie E; Fu, Qinggong; Rao, Sapna et al. (2018) Quantifying the burden of steroid-related damage in SLE in the Hopkins Lupus Cohort. Lupus Sci Med 5:e000237
Petri, Michelle; Magder, Laurence S (2018) Comparison of Remission and Lupus Low Disease Activity State in Damage Prevention in a United States Systemic Lupus Erythematosus Cohort. Arthritis Rheumatol 70:1790-1795
Choi, May Y; Clarke, Ann E; St Pierre, Yvan et al. (2018) Antinuclear Antibody-Negative Systemic Lupus Erythematosus in an International Inception Cohort. Arthritis Care Res (Hoboken) :
Hardt, Uta; Larsson, Anders; Gunnarsson, Iva et al. (2018) Autoimmune reactivity to malondialdehyde adducts in systemic lupus erythematosus is associated with disease activity and nephritis. Arthritis Res Ther 20:36
Pejchinovski, M; Siwy, J; Mullen, W et al. (2018) Urine peptidomic biomarkers for diagnosis of patients with systematic lupus erythematosus. Lupus 27:6-16

Showing the most recent 10 out of 220 publications