Floris et al reviewed the correlation between serum anti-dsDNA (double-stranded DNA) concentrations and clinical flares in patients with systemic lupus erythematosus (SLE). The relationship between serum anti-dsDNA and flares has not been seen in all studies. The authors are from University of Cagliari in Italy.
Patient selection: systemic lupus erythematosus (SLE)
Flare in SLE: onset of new SLE manifestation or worsening of an existing one, with change in therapy
The primary predictor of flares was fluctuating or rising anti-dsDNA serum concentrations
Other markers may include:
(1) falling C3 and/or C4 serum concentrations
(2) higher ESR or serum CRP
If therapy was modified when serum anti-dsDNA has increased by >= 50%, then flares may be prevented.
Therapeutic modification included increase in: corticosteroids, antimalarials, azathioprine, methotrexate, cyclosporine, cyclophosphamide, mycophenolate mofetil, rituximab, other biological agent
Reasons for inconsistencies in studies:
(1) differences in laboratory methods
(2) variation in patient characteristics (ethnicity, disease severity, disease duration, therapy, disease duration)
(3) follow-up
