Systemic Lupus Erythematosus with and without Anti‐dsDNA Antibodies: Analysis from a Large Monocentric Cohort

Objectives. The anti‐dsDNA antibodies are a marker for Systemic Lupus Erythematosus (SLE) and 70–98% of patients test positive. We evaluated the demographic, clinical, laboratory, and therapeutical features of a monocentric SLE cohort according to the anti‐dsDNA status. Methods. We identified three groups: anti‐dsDNA + (persistent positivity); anti‐dsDNA ± (initial positivity and subsequent negativity during disease course); anti‐dsDNA − (persistent negativity). Disease activity was assessed by the European Consensus Lupus Activity Measurement (ECLAM). Results. We evaluated 393 patients (anti‐dsDNA +: 62.3%; anti‐dsDNA ±: 13.3%; anti‐dsDNA −: 24.4%). The renal involvement was significantly more frequent in anti‐dsDNA + (30.2%), compared with anti‐dsDNA ± and anti‐dsDNA − (21.1% and 18.7%, resp.; P = 0.001). Serositis resulted significantly more frequent in anti‐dsDNA − (82.3%) compared to anti‐dsDNA + and anti‐dsDNA ± (20.8% and 13.4%, resp.; P < 0.0001). The reduction of C4 serum levels was identified significantly more frequently in anti‐dsDNA + and anti‐dsDNA ± (40.0% and 44.2%, resp.) compared with anti‐dsDNA − (21.8%, P = 0.005). We did not identify significant differences in the mean ECLAM values before and after modification of anti‐dsDNA status (P = 0.7). Conclusion. Anti‐dsDNA status influences the clinical and immunological features of SLE patients. Nonetheless, it does not appear to affect disease activity.