Reoccurring and Persistent High Disease Activity in Lupus Linked to Increased Damage Accrual

For people with lupus, reoccurring, persistent or longer-lasting episodes of High Disease Activity Status (HDAS) is linked to an increased risk of organ damage accrual. HDAS is defined as having a disease activity score, or Systemic lupus erythematosus disease activity index 2000 score (SLEDAI-2K), of 10 or greater. Damage accrual refers to any permanent injury to the body’s tissues, such as the heart or kidneys, which may lead to other serious illnesses.

Researchers assessed the medical records of 342 people with lupus were who had been followed by their healthcare provider for at least one year. Of the participants included in the study:

• The majority (76%) experienced Recurrent HDAS, defined as having more than one HDAS clinic visit.
• Nearly half (48%) experienced Persistent HDAS, defined as having two or more HDAS clinic visits in a row for more than two months.

Recurrent and Persistent HDAS were both associated with organ damage accrual. People in both groups were younger at the time of their diagnosis, and they were more likely to experience kidney problems or inflammation of the body’s internal tissue lining. Additionally, those with Persistent HDAS were also more likely to develop neurological (nervous system) issues.

Long-lasting HDAS (persisting more than two years) and more frequently reoccurring episodes of HDAS (four or more episodes) were also associated with an increased risk of organ damage accrual. However, HDAS episodes lasting two or more years had a greater effect on damage accrual than the number of relapses or individual episodes. Additionally, higher levels of disease activity at the onset of an HDAS episode was associated with longer-lasting episodes.

These findings suggest that even brief periods of low levels of disease activity can reduce risk of damage accrual, demonstrating the importance of lupus disease management. Learn about the dos and don’ts of living well with lupus.

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