High incidence of steroid complications related to cumulative steroid dose in systemic lupus erythematosus patients over the age of 50

1997 ◽  
Vol 6 (3) ◽  
pp. 141-147
Author(s):  
Domingo gnHernández ◽  
Aurelio Rodríguez ◽  
Margarita Rufino ◽  
Victor Lorenzo ◽  
Eduardo de Bonis ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Steroid Dose ◽  
High Incidence

The Early Protective Effect of Hydroxychloroquine on the Risk of Cumulative Damage in Patients with Systemic Lupus Erythematosus

2013 ◽  
Vol 40 (6) ◽  
pp. 831-841 ◽  
Author(s):  
Pooneh S. Akhavan ◽  
Jiandong Su ◽  
Wendy Lou ◽  
Dafna D. Gladman ◽  
Murray B. Urowitz ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Conditional Logistic Regression ◽  
Univariate Analysis ◽  
Damage Index ◽  
Immunosuppressive Drugs ◽  
Clinical Effects ◽  
Systemic Lupus ◽  
Steroid Dose ◽  
Damage Accrual

Objective.To assess whether hydroxychloroquine (HCQ) prevents early damage in patients with systemic lupus erythematosus (SLE).Methods.We updated an existing systematic review of literature on clinical effects of HCQ in patients with SLE. We conducted a nested case-control study embedded in an inception cohort of patients with SLE. Systemic Lupus International Collaborating Clinics Damage Index (SDI) at 3 years was considered as our primary outcome. Patients with SDI > 0 at 3 years were considered cases and patients with SDI = 0 were controls. Cases and controls were first compared by univariate analysis. Then conditional logistic regression models adjusting for potential confounders were done to study the effect of HCQ on damage accrual.Results.Included in the analysis were 481 patients who had 3 or more years of followup. Out of this cohort, we could match 151 cases with 151 controls. Univariate analysis identified age, the use of any immunosuppressive drugs, HCQ, and cumulative dose of steroids as significant covariates associated with damage accrual. In multivariate analysis, the use of HCQ remained significantly associated with less damage (OR 0.34, 95% CI 0.132–0.867), while age (OR 1.05, 95% CI 1.027–1.078) and a variable combining SLE activity and steroid dose (OR 1.73, 95% CI 1.306–2.295) were associated with damage at 3 years.Conclusion.We demonstrated that HCQ use was associated with less damage at 3 years after diagnosis of SLE when attention was given and adjustment done for disease activity and steroid dose, duration of disease, and calendar year of diagnosis.

High incidence and prevalence of systemic lupus erythematosus in Norway

Lupus ◽  
2012 ◽  
Vol 21 (12) ◽  
pp. 1362-1369 ◽  
Author(s):  
K Lerang ◽  
I Gilboe ◽  
T Garen ◽  
DS Thelle ◽  
JT Gran
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
High Incidence

Preliminary study on the changes of ovarian reserve, menstruation, and lymphocyte subpopulation in systemic lupus erythematosus (SLE) patients of childbearing age

Lupus ◽  
2017 ◽  
Vol 27 (3) ◽  
pp. 445-453 ◽  
Author(s):  
H Gao ◽  
J Ma ◽  
X Wang ◽  
T Lv ◽  
J Liu ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
T Lymphocytes ◽  
Ovarian Reserve ◽  
Lupus Erythematosus ◽  
Lymphocyte Subpopulation ◽  
Control Group ◽  
Childbearing Age ◽  
Systemic Lupus ◽  
High Incidence ◽  
Normal Menstruation

Objective The main aim of this study was to investigate the ovarian reserve, menstruation, and lymphocyte subpopulation in systemic lupus erythematosus (SLE) patients of childbearing age. Methods We enrolled 40 SLE patients of childbearing age and 40 age-matched healthy controls. Anti-Müllerian hormone (AMH) was tested by electrochemiluminescence, and lymphocyte subsets were tested by flow cytometry. Menstruation situation was obtained by interview. Results The AMH level of the SLE group was significantly lower than that of the control group ( p < 0.001), which was negatively correlated with erythrocyte sedimentation rate (ESR ( r = −0.316, p = 0.047)) and disease activity (SLEDAI ( r = −0.338, p = 0.033)). The AMH concentration of SLE patients with normal menstruation was higher than those with abnormal menstruation ( p < 0.001). The percentages of CD4+ T lymphocytes and NK (natural killer) cells in the SLE group were significantly lower than those in the control group ( p < 0.001). However, the percentages of B cells and CD8+ T lymphocytes in the SLE group were higher than those in the control group ( p < 0.05). Conclusion Decreased AMH and high incidence of abnormal menstruation indicated that autoimmunity activities of SLE can impair the ovarian reserve of female patients. Lymphocytes in SLE patients were in a state of disorder.

scholarly journals FRI0172 THE INFLUENCE OF CALCINEURIN INHIBITORS ON DEVELOPMENT OF CANCER IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A RETROSPECTIVE OBSERVATIONAL STUDY IN THE LUNA REGISTRY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 670.1-670
Author(s):  
K. Ichinose ◽  
T. Igawa ◽  
M. Okamoto ◽  
A. Takatani ◽  
N. Yajima ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Multivariate Analysis ◽  
Lupus Erythematosus ◽  
Cervical Dysplasia ◽  
Calcineurin Inhibitors ◽  
Smoking History ◽  
Systemic Lupus ◽  
Treatment History ◽  
Steroid Dose ◽  
Risk Of Cancer

Background:It has been reported that the incidence of cancer in patients with systemic lupus erythematosus (SLE) is higher than that in healthy individuals, but the findings are inconsistent1. In the transplantation field, a few studies indicated an association between the use of immunosuppressants and an increased risk of cancer2. Calcineurin inhibitors (CNIs), which include cyclosporine and tacrolimus, have been used for >30 years to treat renal and extrarenal manifestations of SLE, but the effects of exposure to CNIs among SLE patients have not been established.Objectives:We investigated the incidence of various cancers (including cervical dysplasia) among SLE patients registered in the LUpus registry of NAtionwide institution (LUNA). We also investigate whether the registrants’ exposure to CNIs increased the risk of cancer.Methods:We calculated the standardized incidence ratio (SIR) of cancer among SLE patients based on the age-standardized incidence rate of cancer reported by Japan’s Ministry of Health, Labour and Welfare. A multivariate analysis of the risk of cancer was performed using the covariates of age, smoking history, CNI treatment history, maximum steroid dose in the past, and Systemic Lupus International Collaboration Clinics/American College of Rheumatology Damage Index [SDI]) value (excluding the occurrence of cancer) at the time of the patient’s registration.Results:We studied 714 patients (663 females; 88.9%).The median age at registry was 44 [interquartile range (IQR): 35–56] years. The median past max. steroid dose was 40 mg/day (IQR: 30–60 mg/day), and the SDI at registration was 1 (IQR 0–2). Smoking history was present in 248 patients (34.9%), and 53 patients (7.4%) experienced cancer complications. Gynecologic malignancies accounted for 71% of all cancers, including 12 cervical dysplasia cases. The standardized incidence rate of cancer in these SLE patients was 1.46 (95%CI: 1.07–1.85, p<0.01). The multivariate analysis showed that a CNI treatment history was not a risk factor for the development of cancer (OR 1.76, 95%CI: 0.63–4.88, p=0.30). After the covariance was adjusted for the propensity score, the risk of cancer in the CNIs group was not increased compared to the non-CNIs group (adjusted OR 2.46, 95%CI: 0.68–8.91, p=0.20).Conclusion:The incidence of cancer in SLE was higher in the LUNA cohort than in the general population. Our results suggest that CNI treatment for individuals with SLE is not a risk factor for the development of cancer.References:[1]Ladouceur A. et.al, Expert Rev Clin Immunol. 2018 Oct;14(10):793-802.[2]Gutierrez-Dalmau A. et.al, Drugs 2007;67(8):1167-98.Disclosure of Interests:None declared

THU0273 DISEASE ACTIVITY IS IMPORTANT RISK FACTORS FOR MATERNAL AND FETAL OUTCOMES DURING PREGNANCY IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 363-363
Author(s):  
J. W. Kim ◽  
J. Y. Jung ◽  
H. A. Kim ◽  
C. H. Suh
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Logistic Regression ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Pregnancy Outcomes ◽  
Odds Ratio ◽  
Systemic Lupus ◽  
Steroid Dose ◽  
Adverse Pregnancy

Background:Systemic lupus erythematosus (SLE) primarily affects women of childbearing age and disease activity frequently increase during pregnancy. Patient with SLE still have markedly higher risk for obstetric complications, despite discussing reproductive planning with physicians and choosing a suitable time for pregnancy.Objectives:This study aimed to examine the frequency and risk factors of complications occurring during pregnancy for women with SLE and compare with the general obstetric population.Methods:The medical records of patients with SLE and age-matched controls at Ajou University Hospital between January 1999 and June 2019 were collected and retrospectively analyzed. Clinical features and pregnancy complications for all pregnancy-related admissions for women with and without SLE were compared. Multivariate logistic regression analysis was performed to obtain the predictor of maternal and fetal adverse outcomes.Results:During this period, we analyzed 163 pregnancies in patients with SLE and 596 pregnancies in general population. Of these, except for body mass index (BMI), no other significant differences regarding demographic characteristics were noted between the groups. Lupus patients delivered significantly earlier(37 weeks + 0 days vs. 37 weeks + 6 days, p<0.001) and experienced more stillbirth (odds ratio (OR) 12.8), pre-eclampsia (OR 4.2), preterm labor (OR 2.6), emergency cesarean section (OR 2.5) and intrauterine growth retardation (odds ratio: 2.4) than age-matched controls. Using logistic regression, thrombocytopenia, low complement levels, high proteinuria, anti-ds DNA antibody positivity and high SLE Disease Activity Index (SLEDAI) were associated with maternal and fetal complications, whereas high cumulative steroid dose after SLE onset, high median steroid dose during pregnancy and history of cyclophosphamide treatment were only correlated with maternal complications. The area under the curve for SLEDAI score of adverse pregnancy outcome was 0.726 (95% CI 0.65-0.81) and cumulative steroid dose after SLE onset and median steroid dose during pregnancy for maternal outcome were 0.658 (95% confidence interval (CI) 0.55-0.76) and 0.750 (95% CI 0.65-0.85). The optimal cut-off value for SLEDAI was 4 and cumulative and median steroid dose were 2750mg and 6mg, respectively.Conclusion:Pregnant women with SLE have a higher risk of adverse pregnancy outcomes. Pregnancies should be delayed until disease activity is well controls (SLEDAI<4) for longer than 6 months.References:[1]L-W Kwok, LS Tam, TY Zhu, et al., Predictors of maternal and fetal outcomes in pregnancies of patients with systemic lupus erythematosus. Lupus 2010;20:781-791[2]E Sugawara, M Kato, Y Fugieda, et al., Pregnancy outcomes in women with rheumatic disease: a real-world observational study in Japan. Lupus 2019;28:1407-1416[3]M Clowse, M Jamison, E Myers, et al., A national study of the complications of lupus in pregnancy. Am J Obstet Gynecol 2008;199:127.e1-127.e6Disclosure of Interests:None declared

scholarly journals Assessment of severity and pattern of irreversible organ damage in patients with systemic lupus erythematosus and systemic scleroderma

2019 ◽  
Vol 1 (18) ◽  
pp. 30-33
Author(s):  
A. V. Petrov ◽  
A. S. Gaffarova
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Cranial Nerves ◽  
Damage Index ◽  
Organ Damage ◽  
The Body ◽  
Systemic Scleroderma ◽  
Systemic Lupus ◽  
High Incidence ◽  
Cerebral Circulation Disorders

The article is devoted to the study of the degree and pattern of irreversible changes in the organs and systems of the body using the SLICC damage index in patients with systemic lupus erythematosus (SLE) and systemic scleroderma (SSc) with a disease duration of more than 5 years. Data were obtained from a high incidence of adverse changes in patients with SLE and SSc. In patients with SLE, adverse changes in the cardiovascular system, central nervous system in the form of acute cerebral circulation disorders and seizures, as well as venous thrombosis, damage to the organ of vision in the form of cataracts, proteinuria (more than 3.5 g per day) and alopecia prevailed. Patients with SSc more often developed lesions of the respiratory organs in the form of pulmonary fibrosis and pulmonary hypertension, the musculoskeletal system, skin and neuropathy of the cranial nerves and peripheral nerves.

Sign in / Sign up

Export Citation Format

Share Document