دورية أكاديمية
Predictive factors of flares in systemic lupus erythematosus patients: data from a multiethnic Latin American cohort.
| العنوان: | Predictive factors of flares in systemic lupus erythematosus patients: data from a multiethnic Latin American cohort. |
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| المؤلفون: | Ugarte-Gil MF; 1 Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Perú.; 2 Universidad Científica del Sur, Lima, Perú., Wojdyla D; 3 Universidad Nacional de Rosario, Rosario, Argentina., Pastor-Asurza CA; 1 Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Perú.; 4 Universidad Nacional Mayor de San Marcos, Lima, Perú., Gamboa-Cárdenas RV; 1 Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Perú., Acevedo-Vásquez EM; 1 Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Perú.; 4 Universidad Nacional Mayor de San Marcos, Lima, Perú., Catoggio LJ; 5 Sección de Reumatología, Servicio de Clínica Médica, Hospital Italiano, Instituto Universitario Escuela de Medicina Hospital Italiano and Fundación Dr. Pedro M. Catoggio para el Progreso de la Reumatología, Buenos Aires, Argentina., García MA; 6 Hospital Interzonal General de Agudos 'General San Martín,' La Plata, Argentina., Bonfá E; 7 Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Sato EI; 8 Disciplina de Reumatología, Escola Paulista de Medicina, Universidade Federal da São Paulo-UNIFESP, São Paulo, Brazil., Massardo L; 9 Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Pascual-Ramos V; 10 Instituto Nacional de Ciencias Médicas y Nutrición 'Salvador Zubirán,' Ciudad de Mexico, Mexico., Barile LA; 11 Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico., Reyes-Llerena G; 12 Centro de Investigaciones Médico Quirúrgicas-CIMEQ, Habana, Cuba., Iglesias-Gamarra A; 13 Universidad Nacional de Colombia, Bogotá, Colombia., Molina-Restrepo JF; 14 Universidad CES, Medellin, Colombia., Chacón-Díaz R; 15 Servicio de Reumatología, Centro Nacional de Enfermedades Reumáticas, Hospital Universitario de Caracas, Caracas, Venezuela., Alarcón GS; 16 Department of Medicine, Division of Clinical Immunology and Rheumatology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA., Pons-Estel BA; 17 Hospital Provincial de Rosario, Rosario, Argentina. |
| المصدر: | Lupus [Lupus] 2018 Apr; Vol. 27 (4), pp. 536-544. Date of Electronic Publication: 2017 Aug 31. |
| نوع المنشور: | Journal Article; Multicenter Study; Observational Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: SAGE Publications Country of Publication: England NLM ID: 9204265 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-0962 (Electronic) Linking ISSN: 09612033 NLM ISO Abbreviation: Lupus Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: London : SAGE Publications Original Publication: Houndmills, Basingstoke, Hampshire, UK : Scientific & Medical Division, Macmillan Press Ltd., c1991- |
| مواضيع طبية MeSH: | Antimalarials/*therapeutic use , Glucocorticoids/*therapeutic use , Immunosuppressive Agents/*therapeutic use , Lupus Erythematosus, Systemic/*drug therapy, Adolescent ; Adult ; Age Factors ; Antimalarials/adverse effects ; Case-Control Studies ; Female ; Glucocorticoids/adverse effects ; Humans ; Immunosuppressive Agents/adverse effects ; Latin America/epidemiology ; Logistic Models ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/ethnology ; Male ; Multivariate Analysis ; Odds Ratio ; Protective Factors ; Remission Induction ; Risk Factors ; Time Factors ; Treatment Outcome ; Young Adult |
| مستخلص: | Purpose The purpose of this paper is to determine the factors predictive of flares in systemic lupus erythematosus (SLE) patients. Methods A case-control study nested within the Grupo Latino Americano De Estudio de Lupus (GLADEL) cohort was conducted. Flare was defined as an increase ≥4 points in the SLEDAI. Cases were defined as patients with at least one flare. Controls were selected by matching cases by length of follow-up. Demographic and clinical manifestations were systematically recorded by a common protocol. Glucocorticoid use was recorded as average daily dose of prednisone and antimalarial use as percentage of time on antimalarial and categorized as never (0%), rarely (>0-25%), occasionally (>25%-50%), commonly (˃50%-75%) and frequently (˃75%). Immunosuppressive drugs were recorded as used or not used. The association between demographic, clinical manifestations, therapy and flares was examined using univariable and multivariable conditional logistic regression models. Results A total of 465 cases and controls were included. Mean age at diagnosis among cases and controls was 27.5 vs 29.9 years, p = 0.003; gender and ethnic distributions were comparable among both groups and so was the baseline SLEDAI. Independent factors protective of flares identified by multivariable analysis were older age at diagnosis (OR = 0.929 per every five years, 95% CI 0.869-0.975; p = 0.004) and antimalarial use (frequently vs never, OR = 0.722, 95% CI 0.522-0.998; p = 0.049) whereas azathioprine use (OR = 1.820, 95% CI 1.309-2.531; p < 0.001) and SLEDAI post-baseline were predictive of them (OR = 1.034, 95% CI 1.005-1.064; p = 0.022). Conclusions In this large, longitudinal Latin American cohort, older age at diagnosis and more frequent antimalarial use were protective whereas azathioprine use and higher disease activity were predictive of flares. |
| فهرسة مساهمة: | Keywords: Systemic lupus erythematosus; antimalarials; flares; risk factors |
| المشرفين على المادة: | 0 (Antimalarials) 0 (Glucocorticoids) 0 (Immunosuppressive Agents) |
| تواريخ الأحداث: | Date Created: 20170901 Date Completed: 20180917 Latest Revision: 20180917 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1177/0961203317728810 |
| PMID: | 28857715 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1477-0962 |
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| DOI: | 10.1177/0961203317728810 |