Burden of comorbidities in South Africans with systemic lupus erythematosus

Greenstein, L.; Makan, Kavita; Tikly, Mohammed

doi:10.1007/s10067-019-04511-7

Cited by 11 publications

(17 citation statements)

References 26 publications

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“…The association between lupus-related morbidity and medications, is well documented. 20 Also, Thamer et al, had found that the risk of damage accrual increased with the high cumulative dose of prednisone, even after adjusting for multiple variables, including baseline SLE activity, 42 while higher damage SLICC index in comorbidity group may be a result of active disease and the medications used.…”

Section: Discussionmentioning

confidence: 99%

“…It may occur because of the disease itself or the medical intervention. 2,20 Several comorbidities might be encountered in the context of SLE, with hypertension among the commonest, yet with variable prevalence. Prevalence of hypertension varies greatly among different reports; however, it remains among the highly prevalent comorbidities in SLE and is significantly higher than non-SLE within the same age and sex category.…”

Section: Discussionmentioning

confidence: 99%

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Comorbidities among Egyptian systemic lupus erythematosus: The COMOSLE-EGYPT study

et al. 2022

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Objective To study the prevalence and impact of comorbidities among a cohort of patients with systemic lupus erythematosus (SLE). Methods This study is retrospective, multicenter including 902 Egyptian patients with SLE. Medical records were reviewed for demographic data, clinical characteristics, routine laboratory findings, immunological profile, and medications. Moreover, SLE Disease Activity Index (SLEDAI), and the Systemic Lupus International Collaborating Clinics/American College Rheumatology Damage Index scores were calculated. Results Comorbidities were found in 75.5% of the studied group with hypertension and dyslipidemia as the most frequent comorbidities (43.1% and 40.1%, respectively), followed by sicca features, avascular necrosis, diabetes, osteoporosis and renal failure (11.5%,9%, 9%,8.9%, and 7.1%, respectively). Multivariate regression model showed statistically significant relation between the presence of comorbid condition and each of age ( P = 0.006), disease duration ( P = 0.041), SLEDAI at onset ( P < 0.001), cyclophosphamide intake ( P = 0.001), and cumulative pulse intravenous methylprednisone ( P < 0.001). Also, when adjusted to age and sex, those with multiple comorbid conditions had 18.5 increased odds of mortality compared to those without comorbidities (odds ratio (OR), 95% confidence interval (CI) = 18.5 (6.65–51.69)]. Conclusion Patients with SLE suffer from several comorbidities, with an increasing risk with age, longer disease duration, higher SLEDAI at onset, cyclophosphamide intake and cumulative pulse intravenous methylprednisone. Risk of mortality is exponentiated with multiple comorbidities.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comorbidities among Egyptian systemic lupus erythematosus: The COMOSLE-EGYPT study

et al. 2022

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“…Our findings are mostly in line with previous research, although some variation in morbidities has been reported depending on study design and ethnicity. [14][15][16] In a case-control study from UK SLE patients were compared using general practice records. The risk of comorbidities was elevated in almost all disease groups studied, but especially renal diseases and CVDs were more frequent, as it was in our cohort.…”

Section: Discussionmentioning

confidence: 99%

“…However, CVDs, except hypertension, were rare compared to our study or studies performed in other industrial countries. 11,15,17 SLE itself predisposes to CVDs due to endothelial dysfunction. 18,19 Again, metabolic syndrome is more frequent in SLE patients, contributing to the CVD burden.…”

Section: Discussionmentioning

confidence: 99%

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Multimorbidity among incident Finnish systemic lupus erythematosus patients during 2000–2017

Kariniemi

Rantalaiho

Virta

et al. 2020

Lupus

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The objective of the study was to examine the risk of other morbidities among patients with systemic lupus erythematosus (SLE). A total of 1006 adult new-onset SLE patients were identified during 1.1.2000- 31.12.2014 from the register of Social Insurance Institution. For each case three general population controls matched according to age, sex and place of residence at the index day were sampled from the population register. Both groups were followed up from the index date until the end of 2017 or until death. The national register on specialized care was explored to gather broadly their 12 organ-specific morbidities, which were found among 91.2% of SLE patients and 66.7% of comparators. The rate ratio (RR) was elevated in almost all disease groups. Musculoskeletal, cardiovascular and genitourinary conditions were the most common comorbidities with RRs of 1.82 (1.68 to 1.97), 1.91 (1.76 to 2.08) and 1.91 (1.73 to 2.09), respectively. Men with SLE had a significantly higher risk for diseases of the genitourinary system and endocrine, nutritional and metabolic diseases compared to women with SLE. The risk of concurrent morbidities is essential to note in the care of SLE patients.

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Causes and predictors of mortality in South Africans with systemic sclerosis

Dire

Ickinger

Tikly

2023

Rheumatology & Autoimmunity

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BackgroundThere is a dearth of mortality data on systemic sclerosis (SSc) in sub‐Saharan Africa. We undertook a retrospective study of causes and predictors of death in low‐income indigent South Africans with SSc.MethodsA retrospective records review of clinicodemographic, laboratory, and outcome data of SSc patients attending a state‐funded tertiary Rheumatology service in South Africa.ResultsMost of the 164 patients were Black (92.7%) and female (87.8%). The mean (SD) age at diagnosis and follow‐up duration were 42.6 (12.9) and 5.5 (5.6) years, respectively. The majority (75.6%) had diffuse cutaneous SSc (dcSSc); and digital pits/ulcers, interstitial lung disease (ILD), and pulmonary hypertension (PH) were documented in 73.6%, 55.0%, and 38.3%, respectively. There were 56 known deaths and an equal number of patients were lost to follow‐up. Deaths resulted from ILD complicated by PH (42.9%), infections (8.9%), cardiac disease (7.1%), and malignancies (3.6%). Estimated 5‐ and 10‐year survival rates for patients with known outcomes were 58% and 42%, respectively. Independent predictors of death were renal dysfunction and cor pulmonale.ConclusionMost patients in this study of South Africans had dcSSc and poor outcomes. Known deaths resulted from cardiorespiratory complications of ILD complicated by PH. Cor pulmonale and renal dysfunction were independent predictors of death.

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Burden of comorbidities in South Africans with systemic lupus erythematosus

Cited by 11 publications

References 26 publications

Comorbidities among Egyptian systemic lupus erythematosus: The COMOSLE-EGYPT study

Comorbidities among Egyptian systemic lupus erythematosus: The COMOSLE-EGYPT study

Multimorbidity among incident Finnish systemic lupus erythematosus patients during 2000–2017

Causes and predictors of mortality in South Africans with systemic sclerosis

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