title: Anti-dsDNA and anti-Sm antibodies do not predict damage in systemic lupus erythematosus.
abstract: We aimed to determine whether anti-dsDNA and anti-Sm antibodies predict damage in systemic lupus erythematosus (SLE). Five-hundred inception patients from the University of Toronto Lupus Clinic were studied. Predictors assessed for the entire study period were: (1) raised anti-dsDNA on two consecutive occasions; (2) anti-dsDNA levels (normal, mildly or highly elevated); (3) presence of antiSm on any occasion. To account for disease duration, the following were assessed at three years post-inception: raised anti-dsDNA on two consecutive occasions; anti-dsDNA levels. These predictors were correlated with the following outcomes: (1) overall SLICC/ACR Damage Index (SDI) at the end of the study period; (2) frequency of damage in the cardiovascular, neuropsychiatric, musculoskeletal and renal components of SDI; ((3) SDI at five years for the predictors assessed at three years post-inception. In the multivariate analysis, presence of anti-DNA antibodies or of anti-SM were non-significant but sex, age at SLE diagnosis, disease duration, corticosteroid use and cumulative dose were strong predictors of damage. Raised anti-dsDNA on two occasions or anti-dsDNA levels in the three years post-inception patients did not predict damage at five years. The presence and levels of anti-dsDNA and anti-Sm antibodies do not predict damage in SLE.
authors.affiliation: University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Prasad
authors.forename: D
authors.initials: D
authors.lastname: Ibañez
authors.forename: D
authors.initials: D
authors.lastname: Gladman
authors.forename: M
authors.initials: M
authors.lastname: Urowitz
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000974:Antibodies, Antinuclear / Q000032:analysis* / Q000145:classification / Q000276:immunology*; D044466:Asian People; D044383:Black People; D017691:Caribbean Region; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000208:ethnology / Q000276:immunology*; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D044465:White People
chemical_list: D000305:Adrenal Cortex Hormones; D000974:Antibodies, Antinuclear