CHARACTERISTICS OF PATIENTS WITH INTERMITTENT AND PERSISTENT TYPE 2 SLE
Notice bibliographique
Résumé
PV207 / #177 Poster Topic: AS23 - SLE-Diagnosis, Manifestations, & Outcomes Background/Purpose Our prior qualitative work demonstrated there are at least 2 distinct subgroups of Type 2 SLE; one is related to active inflammation (Intermittent Type 2 SLE) and another can be present regardless of inflammation (Persistent Type 2 SLE). The objective of this study was to utilize longitudinal measures of Type 1 and Type 2 SLE activity to characterize these Type 2 SLE subgroups. Methods SLE patients meeting SLICC or ACR criteria were enrolled in a university lupus registry. At each clinic visit, participants completed the Polysymptomatic Distress Scale (PSD), and rheumatologists completed disease activity measures, including the SLEDAI and Physician Global Assessments (PGA) for both Type 1 and Type 2 SLE activity. Patients seen between May 2023 and April 2024 were invited to participate in a substudy that included the FACIT-fatigue scale; PROMIS measures for pain intensity, pain interference, self-efficacy, and psychological stress; and the Trauma History Screen. Only patients who participated in the substudy and had ≥3 visits in the registry were included in the analysis. High Type 1 SLE activity was defined as clinical SLEDAI ≥4, SLEDAI ≥6, active lupus nephritis or PGA ≥1. High Type 2 SLE activity was defined as Type 2 PGA ≥1 or PSD ≥8. Patients who had high Type 1 SLE activity at <30% of visits and high Type 2 SLE activity at ≥50% of visits were classified as Persistent Type 2 SLE. Patients who had fluctuating Type 2 SLE activity were classified as Intermittent Type 2 SLE. Patients who never had high Type 2 SLE activity during follow-up (n=13) were excluded from the analysis. Differences in characteristics between the 2 groups were estimated by t-tests and Fisher’s exact tests. Results The analysis included 183 patients (mean age 45 years, 92% female, 60% Black); 26% of patients had Persistent Type 2 SLE. Demographics were similar between the 2 groups (Table 1). Patients with Persistent Type 2 SLE were more likely to have experienced abusive trauma. While patients with Intermittent Type 2 SLE had higher Type 1 SLE activity over time, approximately half of patients in each group had a history of lupus nephritis, and there were no differences between groups in historical use of prednisone, DMARDs, or biologics. Patients in the Persistent Type 2 SLE group were more likely to have been prescribed a Type 2 SLE medication and to have been prescribed more Type 2 SLE medications over time. By definition, patients with Persistent Type 2 SLE had higher PSD scores during follow-up, yet patients with Intermittent Type 2 SLE still had mild to moderate PSD scores, on average, during follow-up. There were similar self-efficacy scores for managing medications between groups, yet patients with Persistent Type 2 SLE had lower self-efficacy for managing symptoms; they also had worse scores for FACIT-fatigue, PROMIS pain intensity, and pain interference. Table 1. Cohort characteristics. Conclusions One in 4 patients met our study definition for Persistent Type 2 SLE. Despite having taken on average 4 different medications to treat Type 2 SLE symptoms, patients with Persistent Type 2 SLE continued to have a high burden of pain, fatigue, depression, and brain fog, demonstrating a need for better treatment approaches. Several psychosocial stressors could predispose or perpetuate Persistent Type 2, and future work will evaluate these triggers to better understand the etiology and target solutions for these symptoms.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».