Predicting progression from undifferentiated connective tissue disease to definite connective tissue disease: A systematic review and meta-analysis

Dyball, Sarah; Rodziewicz, Mia; Mendoza‐Pinto, Claudia; Bruce, Ian N.; Parker, Ben

doi:10.1016/j.autrev.2022.103184

Cited by 12 publications

(12 citation statements)

References 63 publications

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“…[13][14][15] A retrospective study reported that the factors predictive of SLE development in patients with UCTD included a younger age, serositis, and positivity for anti-dsDNA antibodies. 36 Other studies on AIHA and ITP patients, both younger age and ANA positivity were significantly correlated with an increased risk of developing SLE. 14,15 These findings share a similarity with results of our study that certain serologic features could serve as predictors for the development of SLE.…”

Section: Discussionmentioning

confidence: 78%

Predictors for future development of systemic lupus erythematosus in Korean Sjögren’s syndrome patients

Lee,

Kwon,

Park

et al. 2023

Lupus

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Objective This study determined the impact of demographic factors, clinical manifestations, disease activity, and serological tests at baseline on future SLE development in Sjögren’s syndrome (SS) patients. Methods This retrospective study assessed 1,082 SS patients without other autoimmune diseases at baseline who visited our hospital between January 2012 and March 2021. We analyzed demographic features, extra-glandular manifestations (EGMs), clinical indices, and laboratory values at baseline between the two groups divided per future SLE development (SS/SLE group vs SS group). The probability and predictors of SLE development in SS patients were estimated using the Kaplan–Meier method and Cox proportional hazards models. Results The median follow-up duration was 1083.5 days. Forty-nine patients (4.5%) developed SLE that met the 2012 Systemic Lupus International Collaborating Clinics or 2019 EULAR/ACR classification criteria. The baseline EULAR SS disease activity index (ESSDAI) score was significantly higher in the SS/SLE group ( p < .001). The SS/SLE group had more lymphadenopathy and renal involvement ( p = .015 and p = .017, respectively). Shorter SS disease duration (<3 years) (hazard ratio [HR] = 2.12, p = .0328), high ESSDAI (HR = 8.24, p < .0001), leukopenia (HR = 4.17, p = .0005), thrombocytopenia (HR = 3.38, p = .0059), hypocomplementemia (HR = 29.06, p<.0001), and positive for anti-dsDNA (HR = 13.70, p < .0001), anti-ribonucleoprotein (RNP) (HR = 3.82, p = .0027), and anti-ribosomal P (HR = 6.70, p = .0002) at baseline were SLE development predictors in SS patients. Conclusion Shorter disease duration and higher disease activity of SS at baseline may be risk factors for future SLE development. Serologic predictors of SLE development are hypocomplementemia, leukopenia, thrombocytopenia, and positivity for anti-dsDNA, anti-RNP, and anti-ribosomal P antibodies. If the above factors are observed, close monitoring will be necessary during the follow-up period, considering the possibility of future SLE development.

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Section: Discussionmentioning

confidence: 78%

Predictors for future development of systemic lupus erythematosus in Korean Sjögren’s syndrome patients

Lee,

Kwon,

Park

et al. 2023

Lupus

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“…Although the newly diagnosed SLE group was small, this behaviour reinforces the need to monitor patients with a positive solid-phase dsDNA assay result, as recently reviewed. 20 21 …”

Section: Discussionmentioning

confidence: 99%

Longitudinal study of patients with discrepant results in CLIFT and a solid-phase dsDNA antibody assay: does a gold standard dsDNA assay exist?

Trujillo Aguilera,

Bernardo Serrano,

Navas

et al. 2023

Lupus Sci Med

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ObjectiveAntidouble-stranded DNA (dsDNA) antibodies are essential for diagnosis and follow-up of systemic lupus erythematous (SLE). To ensure the best diagnostic approach, most healthcare laboratories opt for a combination of highly sensitive methods, such as solid-phase immunoassays, and highly specific methods, such as theCrithidia luciliaeindirect immunofluorescence test (CLIFT). Even so, discordant results are common, thus hindering the diagnostic process. Therefore, this study aimed to characterise a cohort of patients with discrepant results for a dsDNA fluorescence enzyme immunoassay (FEIA) and CLIFT during 2016–2018 and to follow patients up until December 2021.MethodsWe performed an observational, longitudinal and retrospective study on 417 samples from 257 patients who had been referred for suspected connective tissue diseases or followed up after diagnosis. All of them were positive for antinuclear antibodies (ANAs) using an indirect immunofluorescence assay (IFA) on Hep-2 cells, the entry criterion in our laboratory, and positive for FEIA dsDNA. Samples were then tested with CLIFT according to our routine protocol, which includes CLIFT testing after FEIA dsDNA results ≥10 UI/ml. After the assessment of data quality, the final analysis was based on 222 patients.ResultsEighty-three patients (37.4%) had positive results in both tests and met the diagnostic criteria for SLE. However, 139 patients (62.6%) had discrepant results (FEIA+, CLIFT–). Of these, 58 patients (41.7%) had a diagnosis of SLE, with 47 (33.8%) having been previously diagnosed and under treatment. The remaining 11 patients (7.9%) had a new diagnosis of SLE, which was made up within 4 years of the initial screening. A total of 81 of the 139 patients (57.5%) with discrepant results did not meet lupus criteria during the follow-up period.ConclusionsThe study showed that CLIFT could be negative in both treated and newly diagnosed SLE, thus underlining the importance of follow-up of dsDNA-positive results using solid-phase tests. Therefore, quantitative tests such as FEIA could add value to the diagnosis and management of patients with suspected SLE.

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“…ANA with homogenous pattern, anti-Sm, and hypocomplementemia were also associated with progression to SLE but with a low certainty of evidence. 80…”

Section: Pre-clinical Autoimmunity and Progression To Slementioning

confidence: 99%

The Rise and Rise of Lupus

González

Ugarte‐Gil

Pons-Estel

et al. 2023

Lupus

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Despite how difficult the early diagnosis of systemic lupus erythematosus (SLE) is, which is mainly due to the heterogeneity and non-specificity of its clinical manifestations, SLE is currently being diagnosed more frequently than in past decades. In fact, there has been an increase in the incidence and prevalence of SLE over the last four decades; this can be explained by a number of reasons including a better knowledge of the pathogenesis of the disease which allows its earlier diagnosis, the rising ethnic and racial diversity of the world population, the use of the 2019 EULAR/ACR criteria that allows classifying patients earlier, and improvements in survival over the last decades, which results in an increase in the prevalent cases of SLE. In this article, we will also review the genetic, environmental, and lifestyle factors, that are reported to increase the risk of developing SLE and how preventive strategies through a clinical care pathway may prevent or delay the development of SLE and improve these patients’ outcomes.

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Predicting progression from undifferentiated connective tissue disease to definite connective tissue disease: A systematic review and meta-analysis

Cited by 12 publications

References 63 publications

Predictors for future development of systemic lupus erythematosus in Korean Sjögren’s syndrome patients

Predictors for future development of systemic lupus erythematosus in Korean Sjögren’s syndrome patients

Longitudinal study of patients with discrepant results in CLIFT and a solid-phase dsDNA antibody assay: does a gold standard dsDNA assay exist?

The Rise and Rise of Lupus

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