Disease progression in patients with systemic lupus erythematosus: an analysis of the SLE Prospective Observational Cohort Study (SPOCS)
Bibliographic record
Abstract
OBJECTIVES: We describe disease progression in patients from the SLE Prospective Observational Cohort Study (SPOCS; NCT03189875), investigating differences by baseline IFN gene signature (IFNGS) status. METHODS: Adults with moderate to severe SLE activity receiving standard of care were assessed biannually for ≤36 months post-baseline (study entry). SLEDAI-2000 (SLEDAI-2K), Physician Global Assessment, Safety of Estrogen in Lupus Erythematosus National Assessment (SELENA)-SLEDAI flare number and severity, SLICC/ACR Damage Index (SDI) and remission [Definition of Remission in SLE (DORIS)]/Lupus Low Disease Activity State (LLDAS) attainment were evaluated. RESULTS: At enrolment (n = 826), mean ± s.d. time since SLE diagnosis was 11.1 ± 9.2 years; 70.8% (531/750) of patients were IFNGS-high. At baseline, IFNGS-high vs IFNGS-low patients were younger (42.9 ± 13.6 vs 50.8 ± 12.9 years) and more were using glucocorticoids [68.7% (365/531) vs 56.2% (123/219)]. SLEDAI-2K was higher at baseline, month 6 and month 24 in IFNGS-high patients; SLEDAI-2K decreased from baseline to month 36 (9.8 ± 4.6-5.7 ± 7.7) regardless of baseline IFNGS. SDI was lower at baseline, month 12 and month 24 in IFNGS-high patients, but increased over time regardless of baseline IFNGS. By month 36, 44.7% (183/409) experienced one or more flares; annualized flare rates were higher in IFNGS-high vs IFNGS-low patients at months 30 and 36. DORIS remission or LLDAS was attained by <15% and <20% of patients at any timepoint, with no differences between IFNGS groups except lower remission attainment in IFNGS-high patients at month 6. CONCLUSION: In the SPOCS cohort, disease activity was stable or reduced over time, but treatment target attainment was low and organ damage increased. At month 36, there were no clear differences by baseline IFNGS. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov; NCT03189875.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".