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Massimo Radin, MD, PhD: Low Complement Levels in Early Pregnancy Predicts Disease Flare in SLE 

Massimo Radin, MD, PhD, discusses how low complement levels in the first trimester can predict disease flare in pregnant patients with systemic lupus erythematosus.

Rheumatology Network interviewed Massimo Radin, MD, PhD, to discuss his upcoming European Alliance of Associations for Rheumatology (EULAR) 2022 presentation, “Low Complement Levels in the First Trimester Predict Disease Flare in SLE Pregnancy: A Network Meta-Analysis on 532 Patients.” Radin is a researcher at the University of Torino (UNITO).

“For this study, the methodology was a little bit different because we wanted to include a large cohort of patients without performing a traditional systematic review, where if you had missing data, you lose those patients. We wanted to be more thorough in our data analysis,” Radin explained.

Investigators collected data on all perspective pregnancies in women with systemic lupus erythematosus (SLE) that were currently available in the literature. They then contacted the lead investigators of those studies to collaborate and obtain additional information on how complement evolved during pregnancy. Ultimately, 12 studies were included in the analysis, evaluating over 500 patients.

“We know that monitoring complement is important in [patients with SLE], but the fluctuation of complement during pregnancy makes it harder,” Radin stated. Therefore, it is critical that rheumatologists monitor these levels. Tracking complement levels of patients with SLE is important because, generally, an increase of complement levels can correlate with disease activity and subsequent flares.

“Of course, [while] this is true for a lot of patients, for some [patients with SLE], this isn't true. This might be because some of the patients that we see have stronger genetic factors that are associated with complement that are the directly responsible for their SLE pathogenesis,” Radin noted.