Factors predictive of high disease activity early in the course of SLE in patients from a Latin-American cohort

Pimentel-Quiroz, Víctor R.; Ugarte‐Gil, Manuel F.; Pons‐Estel, Guillermo J.; Soriano, Enrique R.; Saurit, Verónica; Sato, Emília Inoue; Costallat, Lílian Tereza Lavras; Molina, José Fernando; Iglesias-Gamarra, Antonio; Reyes-Llerena, Gil; Neira, Óscar; Barile, Leonor; Silveira, Luis H.; Segami, M I; Chacón-Díaz, Rosa; Wojdyla, Daniel; Alarcón, Graciela S.; Pons-Éstel, Bernardo A

doi:10.1016/j.semarthrit.2017.01.012

Cited by 11 publications

(9 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the early 2000s, GLADEL constituted a Latin American cohort of SLE patients; in the initial publication in 2004, 1214 patients were included; since then, the group has reported on the presentation and course of the disease, paying particular attention to the impact of ethnic (Amerindian vs. non-Amerindian ancestry), socioeconomic status (SES), and demographic features (lower SES, younger age at onset) on the expression of the disease (higher frequency of renal involvement and lymphopenia), its outcome (higher degrees and more rapid development of damage accrual), and its heterogeneity (different degrees of disease severity among the Latin American population). [1][2][3][4][5][6][7] These findings contrast with data from white SLE patients from Europe and North America. 1,[8][9][10] However, disease features among the Mestizo (mixed European and Amerindian ancestry) patients are comparable to the Hispanic patients described in the US-based LUMINA (for Lupus in Minorities: Nature vs. Nurture) cohort.…”

contrasting

confidence: 80%

A Critical Analysis of the First Latin American Clinical Practice Guidelines for the Treatment of Systemic Lupus Erythematosus

et al. 2019

Self Cite

View full text Add to dashboard Cite

contrasting

confidence: 80%

A Critical Analysis of the First Latin American Clinical Practice Guidelines for the Treatment of Systemic Lupus Erythematosus

et al. 2019

Self Cite

View full text Add to dashboard Cite

“…Several benefits of antimalarial use are already well-known: improvement in survival, flare prevention and a longer time to damage accrual. 6,41–43 Currently, many studies have attributed a new benefit to them: protective against the occurrence of any type of infection. 7–11,13,40 This finding is not surprising due to the broad antimicrobial properties of antimalarials.…”

Section: Discussionmentioning

confidence: 99%

Factors predictive of serious infections over time in systemic lupus erythematosus patients: data from a multi-ethnic, multi-national, Latin American lupus cohort

Pimentel-Quiroz

Ugarte‐Gil

Harvey

et al. 2019

Lupus

View full text Add to dashboard Cite

Aim The aim of this study was to identify factors predictive of serious infections over time in patients with systemic lupus erythematosus (SLE). Methods A multi-ethnic, multi-national Latin American SLE cohort was studied. Serious infection was defined as one that required hospitalization, occurred during a hospitalization or led to death. Potential predictors included were sociodemographic factors, clinical manifestations (per organ involved, lymphopenia and leukopenia, independently) and previous infections at baseline. Disease activity (SLEDAI), damage (SLICC/ACR Damage Index), non-serious infections, glucocorticoids, antimalarials (users and non-users), and immunosuppressive drugs use; the last six variables were examined as time-dependent covariates. Cox regression models were used to evaluate the predictors of serious infections using a backward elimination procedure. Univariable and multivariable analyses were performed. Results Of the 1243 patients included, 1116 (89.8%) were female. The median (interquartile range) age at diagnosis and follow-up time were 27 (20–37) years and 47.8 (17.9–68.6) months, respectively. The incidence rate of serious infections was 3.8 cases per 100 person-years. Antimalarial use (hazard ratio: 0.69; 95% confidence interval (CI): 0.48–0.99; p = 0.0440) was protective, while doses of prednisone >15 and ≤60 mg/day (hazard ratio: 4.18; 95 %CI: 1.69–10.31; p = 0.0019) and >60 mg/day (hazard ratio: 4.71; 95% CI: 1.35–16.49; p = 0.0153), use of methylprednisolone pulses (hazard ratio: 1.53; 95% CI: 1.10–2.13; p = 0.0124), increase in disease activity (hazard ratio: 1.03; 95% CI: 1.01–1.04; p = 0.0016) and damage accrual (hazard ratio: 1.22; 95% CI: 1.11–1.34; p < 0.0001) were predictive factors of serious infections. Conclusions Over time, prednisone doses higher than 15 mg/day, use of methylprednisolone pulses, increase in disease activity and damage accrual were predictive of infections, whereas antimalarial use was protective against them in SLE patients.

show abstract

“…Decades of research support the use of HCQ in rheumatic diseases. As a particularly notable example, HCQ use in systemic lupus erythematosus (SLE) reduces disease activity, 12 limits damage accrual 13 and improves survival. 14 In a well-designed placebo-controlled randomised trial, discontinuation of HCQ in patients with stable SLE increased the frequency of disease flares.…”

Section: Maximise Utilitymentioning

confidence: 99%

Festina lente: hydroxychloroquine, COVID-19 and the role of the rheumatologist

et al. 2020

View full text Add to dashboard Cite

Factors predictive of high disease activity early in the course of SLE in patients from a Latin-American cohort

Cited by 11 publications

References 20 publications

A Critical Analysis of the First Latin American Clinical Practice Guidelines for the Treatment of Systemic Lupus Erythematosus

A Critical Analysis of the First Latin American Clinical Practice Guidelines for the Treatment of Systemic Lupus Erythematosus

Factors predictive of serious infections over time in systemic lupus erythematosus patients: data from a multi-ethnic, multi-national, Latin American lupus cohort

Festina lente: hydroxychloroquine, COVID-19 and the role of the rheumatologist

Contact Info

Product

Resources

About