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NANCY PAN, MD HOSPITAL FOR SPECIAL SURGERY NEW YORK JULY 7, 2011 Third Year Pediatric Rheumatology Fellows’ Conference
Background ,[object Object],[object Object],[object Object],[object Object],[object Object]
Is dsDNA antibodies a good biomarker? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],1. Donald, F. and M.M. Ward,  Evaluative laboratory testing practices of United States rheumatologists.  Arthritis Rheum, 1998. 41(4): p. 725-9. 2. Walz LeBlanc, B.A., D.D. Gladman, and M.B. Urowitz,  Serologically active clinically quiescent systemic lupus erythematosus--predictors of clinical flares.  J Rheumatol, 1994. 21(12): p. 2239-41. 3. Gladman, D.D., et al.,  Clinically active serologically quiescent systemic lupus erythematosus.  J Rheumatol, 2003. 30(9): p. 1960-2. 4. Ho, A., et al.,  Decreases in anti-double-stranded DNA levels are associated with concurrent flares in patients with systemic lupus erythematosus.  Arthritis Rheum, 2001. 44(10): p. 2342-9.
Yes: DsDNA Ab relationship with clinical SLE flare ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
No relationship of dsDNA titers with SLE flare  ,[object Object],[object Object],[object Object]
Changes in dsDNA titer altering management ,[object Object],[object Object]
Clinical Question ,[object Object],[object Object],[object Object],[object Object]
Methods  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Definitions ,[object Object],[object Object]
Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Definitions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Definitions ,[object Object],[object Object],[object Object],[object Object]
Outcomes  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
SLE Patients (registry) n=1026 Patients who had their  ds-DNA checked  at least once n=489 Patients with  at least one positive ds-DNA n=285 Patients with  at least one negative dsDNA  n=140 Exclusion: -Pts with <3 tests n=2 -variation over>1 year n=6 -Pts with no DNA flare, n=14 Patients with dsDNA>2+ n=37 n=15 Patients with  dsDNA>3+ n= 94 Exclusion: Patients with  at least one negative dsDNA n=71 n=23 Patients with dsDNA  1 to 4 n=4 Patients with dsDNA flare n=16 Patients with dsDNA  0 to 4 n=7 Patients with dsDNA  0 to 3 n=5 Exclusion: -Pts with no DNA=1: n=19 -Pts with <3 tests n=1 -Pts with no DNA flare n=2  n=1
[object Object],[object Object],[object Object],[object Object]

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Get into the Research

  • 1. NANCY PAN, MD HOSPITAL FOR SPECIAL SURGERY NEW YORK JULY 7, 2011 Third Year Pediatric Rheumatology Fellows’ Conference
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  • 15. SLE Patients (registry) n=1026 Patients who had their ds-DNA checked at least once n=489 Patients with at least one positive ds-DNA n=285 Patients with at least one negative dsDNA n=140 Exclusion: -Pts with <3 tests n=2 -variation over>1 year n=6 -Pts with no DNA flare, n=14 Patients with dsDNA>2+ n=37 n=15 Patients with dsDNA>3+ n= 94 Exclusion: Patients with at least one negative dsDNA n=71 n=23 Patients with dsDNA 1 to 4 n=4 Patients with dsDNA flare n=16 Patients with dsDNA 0 to 4 n=7 Patients with dsDNA 0 to 3 n=5 Exclusion: -Pts with no DNA=1: n=19 -Pts with <3 tests n=1 -Pts with no DNA flare n=2 n=1
  • 16.

Notas del editor

  1. Many authors concluded that anti ds DNA Ab were largely unhelpful in detecting or predicting clinical flare. However, many of us have seen patients developing severe clinical flare, especially Lupus nephropathy following the increase of dsDNA Ab titers. WHAT IF THE QUESTION OF DsDNA could be resolved by looking at it in a new perspective?