Clinical characteristics during diagnosis of a prospective cohort of patients with systemic lupus erythematosus treated in Spanish Departments of Internal Medicine: The RELES study

Canora, Jesús; García, María Concepción; Mitjavila, Francesca; Espinosa, Gerard; Suárez, S.; González-León, Rocío; Sopeña, B.; Boldova, R.; Ruíz-Irastorza, Guillermo

doi:10.1016/j.rceng.2016.09.003

Cited by 4 publications

(9 citation statements)

References 18 publications

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“…These data also emphasize that the differential diagnosis process for SLE is long and requires comprehensive experience with other autoimmune and related diseases. In recent years, several studies have characterized SLE patients in the early phases of the disease, highlighting the importance of non–classification criteria symptoms .…”

Section: Discussionmentioning

confidence: 99%

“…While the median time from clinical presentation of SLE to SLE diagnosis was >1 year, manifestations like thrombocytopenia and nephrotic syndrome were more likely to be associated with acute care management (i.e., hospital admission or urgent referral) and an earlier diagnosis of SLE. Since 1990, different studies have examined clinical manifestations and serologic features at SLE onset; among non‐criteria symptoms, arthralgias, fever, alopecia, RP, non‐hemolytic anemia, and lymphadenopathy were the most frequently reported .…”

Section: Discussionmentioning

confidence: 99%

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How Do Patients With Newly Diagnosed Systemic Lupus Erythematosus Present? A Multicenter Cohort of Early Systemic Lupus Erythematosus to Inform the Development of New Classification Criteria

Mosca

Costenbader

Johnson

et al. 2018

Arthritis & Rheumatology

106

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

How Do Patients With Newly Diagnosed Systemic Lupus Erythematosus Present? A Multicenter Cohort of Early Systemic Lupus Erythematosus to Inform the Development of New Classification Criteria

Mosca

Costenbader

Johnson

et al. 2018

Arthritis & Rheumatology

106

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show abstract

“…Though sex-specific data on pre-index comorbidities in SLE are not available, evidence does suggest that, overall, SLE patients have an increased inflammatory disease burden before diagnosis. In clinical studies, many patients have had nephritis 11,12 or other forms of renal disease 9,10 at diagnosis, and while SLE patients are known to have an elevated risk of cardiovascular events immediately following diagnosis, 28 increased cardiovascular disease before SLE diagnosis has also been reported. Among members of the multinational Systemic Lupus International Collaborating Clinics (SLICC) cohort, prevalence of myocardial infarction around the time of SLE diagnosis (between five years before, and two years following) exceeded the figure reported for the general population (4.8% vs. 0.7%).…”

Section: Discussionmentioning

confidence: 99%

“…Evidence suggests there is an elevated risk of cardiovascular disease 8 during this period and, by the time of diagnosis, many patients already have renal disease, 9,10 including nephritis. 11,12 The investigation of initial symptoms and management of serious health events preceding diagnosis is likely associated with additional medical costs. However, while several estimates are available on the costs of SLE patients following diagnosis, [13][14][15] little is known about the years prior.…”

Section: Introductionmentioning

confidence: 99%

Incremental direct medical costs of systemic lupus erythematosus patients in the years preceding diagnosis: A general population-based study

McCormick

Marra

Sadatsafavi

et al. 2018

Lupus

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Objective We estimated the incremental (extra) direct medical costs of a population-based cohort of newly diagnosed systemic lupus erythematosus (SLE) for five years before and after diagnosis, and the impact of sex and socioeconomic status (SES) on pre-index costs for SLE. Methods We identified all adults newly diagnosed with SLE over 2001-2010 in British Columbia, Canada, and obtained a sample of non-SLE individuals from the general population, matched on sex, age, and calendar-year of study entry. We captured costs for all outpatient encounters, hospitalisations, and dispensed medications each year. Using generalised linear models, we estimated incremental costs of SLE each year before/after diagnosis (difference in costs between SLE and non-SLE, controlling for covariates). Similar models were used to examine the impact of sex and SES on costs within SLE. Results We included 3632 newly diagnosed SLE (86% female, mean age 49.6 ± 15.9) and 18,060 non-SLE individuals. Over the five years leading up to diagnosis, per-person healthcare costs for SLE patients increased year-over-year by 35%, on average, with the biggest increases in the final two years by 39% and 97%, respectively. Per-person all-cause medical costs for SLE the year after diagnosis (Year + 1) averaged C$12,019 (2013 Canadian) with 58% from hospitalisations, 24% outpatient, and 18% from prescription medications; Year + 1 costs for non-SLE averaged C$2412. Following adjustment for age, sex, urban/rural residence, socioeconomic status, and prior year's comorbidity score, SLE was associated with significantly greater hospitalisation, outpatient, and medication costs than non-SLE in each year of study. Altogether, adjusted incremental costs of SLE rose from C$1131 per person in Year -5 (fifth year before diagnosis) to C$2015 (Year -2), C$3473 (Year -1) and C$6474 (Year + 1). In Years -2, -1 and +1, SLE patients in the lowest SES group had significantly greater costs than the highest SES. Unlike the non-SLE cohort, male patients with SLE had higher costs than females. Annual incremental costs of SLE males (vs. SLE females) rose from C$540 per person in Year -2, to C$1385 in Year -1, and C$2288 in Year + 1. Conclusion Even years before diagnosis, SLE patients incur significantly elevated direct medical costs compared with the age- and sex-matched general population, for hospitalisations, outpatient care, and medications.

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“…It is estimated that the SLE incidence is approximately 50-100 per 100 000 people with a ratio of 9:1 in female to male (5,6). Currently, a large number of investigations have devoted into SLE, and great improvements have been achieved in the diagnosis and treatment of SLE (7).…”

Section: Introductionmentioning

confidence: 99%

Relationship between Clinical Systemic Lupus Erythematosus Symptoms and Indexes of Blood, Renal Function, Liver Function and Immunology

Lu¹,

Yang²,

Qu³

et al. 2017

West Indian Med J

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Objective: This paper aimed to study the relationships between clinical systemic lupus erythematosus (SLE) symptoms and indexes of blood, renal function, liver function and immunology. Methods: Total 117 SLE patients were collected, and clinical symptoms and biochemical indexes of blood, renal function, liver function and immunology were determined. Then, adaptive lasso analysis was used to analyse the potential relationship between the clinical symptoms of SLE and biochemical indexes. Results: The present results indicated that pleurisy is closely related to the red blood cells (RBC), haemoglobin (Hb) and urea nitrogen (BUN) with the |βj | values of 0.0045, 0.0168 and 0.0064, respectively; oedema is closely related to the albuminuria and cylindruria with |βj | values of 0.0198 and 0.1170; alopecia has closely correlations with liver damage and aspartate aminotransferase (AST), (|βj | values were 0.0033 and 0.0104); fever is correlated to liver damage (|βj | values were 0.0011); raynaud phenomenon is closely correlated to the triglycerides (TG) and Anti-U1 Ribonucleoprotein (u1RNP) with |βj | value of 0.0012 and 0.0012; facial redness and arthralgia have close correlations with SSA (|βj | value were 0.3580 and 0.0047; arthritis and pericarditis are closely related to antinucleosome antivodies (AnuA) with |βj | values of 0.0038 and 0.0026. Conclusion: The present study indicated that some biochemical, including RBC, Hb, BUN, albuminuria and cylindruria, liver damage, AST, TG, SSA, AnuA and u1RNP, are closely to the prognosis of SLE and it's important to control these biochemical indexes during the treatment period.

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Clinical characteristics during diagnosis of a prospective cohort of patients with systemic lupus erythematosus treated in Spanish Departments of Internal Medicine: The RELES study

Cited by 4 publications

References 18 publications

How Do Patients With Newly Diagnosed Systemic Lupus Erythematosus Present? A Multicenter Cohort of Early Systemic Lupus Erythematosus to Inform the Development of New Classification Criteria

How Do Patients With Newly Diagnosed Systemic Lupus Erythematosus Present? A Multicenter Cohort of Early Systemic Lupus Erythematosus to Inform the Development of New Classification Criteria

Incremental direct medical costs of systemic lupus erythematosus patients in the years preceding diagnosis: A general population-based study

Relationship between Clinical Systemic Lupus Erythematosus Symptoms and Indexes of Blood, Renal Function, Liver Function and Immunology

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