Research & News

RESEARCH AND NEWS

Multiple Definitions of Lupus Remission and Low Disease Activity Linked to Less Damage

A new study demonstrates the importance of striving for remission or low disease activity (LDA) in lupus. Researchers assessed multiple definitions of remission and LDA and found each was associated with less organ or tissue damage.

This study included 1,652 patients from the Systemic Lupus International Collaborating Clinics (SLICC) cohort, which is a multinational, multiethnic cohort with people recently diagnosed with lupus across Asia, Europe and North America.

Four distinct definitions of remission and LDA were assessed: • Remission Off-Treatment: a clinical Systemic Lupus Erythematosus Disease Activity Index (cSLEDAI-2k) score of zero, without prednisone or immunosuppressants (immunosuppressive medications) • Remission On-Treatment: a cSLEDAI-2k score of zero, while taking 5mg or less of prednisone or immunosuppressants • Low Disease Activity: a cSLEDAI-2k score less than or equal to two, without prednisone or immunosuppressants • Modified Lupus Low Disease Activity (mLLDAS): a SLEDAI-2k score less than or equal to four, with no activity in major organ systems, no new disease activity, while taking 7.5mg or less of prednisone and/or immunosuppressants All of the above definitions were associated with less organ or tissue damage, and the longer the individual remained in a state of remission or LDA, the lower the probability of damage accrual was. These disease activity states were also associated with a lower probability of lupus flares and hospitalizations.

Lupus affects everyone differently, which means treatment goals need to be tailored to each individual. Talk to your doctor about your treatment plan and learn more about lupus remission.

Population-Based Research Study Shows Increase In Lupus Disease Rates

New research shows the incidence and prevalence of lupus, classified using EULAR/ACR criteria, in Olmsted County, Minnesota has increased over the last four decades. Incidence of lupus was higher in certain racial and ethnic groups, and occurrence of the disease increased rapidly in the general population. Both prevalence and incidence rates can reveal important trends in disease occurrence. While prevalence includes all cases, both new and preexisting, in the population at a specific time, incidence is limited to new cases only.

Lupus Midwest Network researchers used the population-based study to examine incidence, prevalence, and mortality trends of lupus over four decades (19762018) in Olmsted County, Minnesota. Over a period of 43 years, incidence of lupus increased 2% per year in men and women and across various age groups. Over a 60% increase in lupus incidence was observed in women, and a sixfold increase was seen in men (from 0.55 lupus cases to 3.18 lupus cases per 100,000 people). Lupus incidence was higher in racial and ethnic minorities than in non-Hispanic white people. An increase in lupus prevalence was also noted per 100,000 people (from 30.65 in 1985 to 97.4 in 2015). The researchers found no evidence that the severity of lupus has changed over time.

Rising rates of lupus, which disproportionately impacts people of color, may at least be partially explained by the increasing ethnic and racial diversity of the US population. According to U.S. Census data, the population of non-Hispanic white people continues to decrease from 63.7% to 57.8% in 2020. Learn more about risk factors for developing lupus.

Study Finds mRNA COVID-19 Vaccine and One Booster Dose May Not Fully Protect against Breakthrough Case of Omicron Variant in People with Autoimmune Disease

In people with autoimmune rheumatic diseases (ARDs), such as lupus, the mRNA COVID-19 vaccine and booster dose may not provide broad protection from developing a breakthrough infection (an infection with a virus after you have been vaccinated) of the Omicron variant. A new study finds the mRNA vaccine does not create sufficient antibodies to neutralize a response to (or fully protect against) Omicron.

The blood samples of 94 healthy healthcare workers and 149 people with ARDs, including lupus, were collected. Researchers examined the blood response to Omicron at 15 weeks after a second mRNA COVID-19 vaccine dose or 8 weeks after receiving a third mRNA dose or booster.

People with ARDs exhibited lower response or protection after the second dose to Omicron (11.5%) than the healthy healthcare workers (18.1%). After the third dose, a significant difference in response was observed – 26.8% in people with ARDs versus 50.3% in the healthy group. Within six weeks, significantly lower Omicron-neutralizing responses were observed in the ARDs group compared to the healthcare workers. The results of this study do not mean that the COVID-19 vaccine is no longer effective for people with lupus. But it does highlight that as the virus changes, further research is needed to examine vaccine efficacy in people with autoimmune diseases. Talk to your healthcare provider about COVID-19 vaccination and/or booster shots and about whether you should continue to take other precautions, such as wearing a mask. Learn more about the COVID-19 vaccine and lupus.