Background

Long-term studies characterizing disease course of cutaneous lupus erythematosus (CLE) patients on standard-of-care treatments are lacking.

Objective

We characterized and compared disease course of CLE patients using Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI).

Methods

In total, 83 CLE patients with CLASI scores collected from ≥3 study visits within 2 years had disease activity and damage trends calculated by average change scores (ACS). Trends were classified as improved (ACS ≤−3), worsened (ACS ≥3), or stable (–3 < ACS < 3). Linear regression models compared CLASI trends between groups.

Results

Most patients (72.73%) with initial CLASI activity (CLASI-A) scores >9 (N = 33) had improved disease activity versus 14.00% of those with initial CLASI-A scores ≤9 (N = 50). Linear regression analyses showed significant improvement in CLASI-A scores in patients of minority races (P < .05), with baseline CLASI-A scores >9 (P < .0001), baseline CLASI damage (CLASI-D) scores ≥10 (P = .0001), and CLE disease duration ≤1 year (P = .01). Of 28 patients with baseline CLASI-D scores ≥10, 35.71% had improvements in damage, while 5.26% of patients with initial CLASI-D scores of 5-9 (N = 19) and 0% with initial CLASI-D scores <5 (N = 36) (P = .0005) had improvements.

Limitations

Limitations include small sample size.

Conclusion

Baseline CLASI-A score >9, minority race, and short disease duration predict CLE disease activity improvement. A baseline CLASI-D score ≥10 is associated with disease damage improvement.

中文翻译：

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皮肤红斑狼疮患者疾病活动和损害的自然史

 背景

缺乏描述皮肤红斑狼疮 (CLE) 患者接受标准治疗的病程特征的长期研究。

 客观的

我们使用皮肤红斑狼疮疾病面积和严重程度指数 (CLASI) 来描述和比较 CLE 患者的病程。

 方法

总共有 83 名 CLE 患者，其 CLASI 评分是从 2 年内 ≥ 3 次研究访视中收集的，他们的疾病活动度和损害趋势是通过平均变化评分 (ACS) 计算的。趋势分为改善（ACS ≤−3）、恶化（ACS ≥3）或稳定（–3 < ACS < 3）。线性回归模型比较了各组之间的 CLASI 趋势。

 结果

大多数初始 CLASI 活动 (CLASI-A) 评分 > 9 (N = 33) 的患者 (72.73%) 疾病活动度有所改善，而初始 CLASI-A 评分 ≤ 9 (N = 50) 的患者这一比例为 14.00%。线性回归分析显示，少数民族患者的 CLASI-A 评分显着改善 ( P < .05)，基线 CLASI-A 评分 >9 ( P < .0001)，基线 CLASI 损伤 (CLASI-D) 评分 ≥10 ( P = .0001)，CLE 病程≤1 年 ( P = .01)。在 28 名基线 CLASI-D 评分≥10 的患者中，35.71% 的患者损伤有所改善，而初始 CLASI-D 评分为 5-9 的患者中有 5.26% (N = 19)，初始 CLASI-D 评分 <5 的患者为 0% id=30>P = .0005) 有改进。

 局限性

局限性包括样本量小。

 结论

基线 CLASI-A 评分 >9、少数族裔和短病程可预测 CLE 疾病活动性改善。基线 CLASI-D 评分≥10 与疾病损害改善相关。