scholarly journals P087 Mortality trends from systemic lupus erythematosus in Cuba: 2001-2014

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Halbert Hernández Negrín
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Health Problem ◽  
Time Trends ◽  
Reference Population ◽  
World Health ◽  
Mortality Data ◽  
Systemic Lupus ◽  
Mortality Trends ◽  
Health Organization

Abstract Background/Aims  There is little research on the mortality of Cuban patients with systemic lupus erythematosus (SLE), with not enough impact to recognize SLE as a health problem in the country. Our aim was to identify time trends and geographic variability in the mortality of Cuban patients with SLE. Methods  Mortality data of decedents over 15 years old were retrieved from the Cuban Ministry of Public Health mortality database, based on International Classification of Disease (ICD), Tenth Revision (ICD-10, code M32). We computed age-standardized mortality rate (ASMR) for each year and province as the estimated number of deaths per million inhabitants and its 95% confidence interval (95% CI) using World Health Organization reference population. The 2001-2014 time trends were analyzed using Jointpoint software. Results  Between 2001 and 2014, 1,054 deaths from SLE were found, mostly women (89.0%), white (54.4%) with a median age of 43 years (interquartile range: 34-53). In 2014 the ASMR caused by SLE per million inhabitants was 14.4 (95% CI: 10.9 to 18.4) in women and 1.3 (95% CI: 0.5 to 3.2) in men. A growing time trend was identified in the ASMR by SLE throughout the period (average annual percentage change [AAPC]: 1.6; 95% CI: 0.6 to 2.6), highest in males (AAPC: 5.6; 95% CI: 1.7 to 9.7) than in females (AAPC: 1.2; 95% CI: 0.3 to 2.0). The highest mortality in women was concentrated in the provinces of Camagüey, Las Tunas and Granma, and in the case of men, in Havana and Ciego de Ávila. Conclusion  The variation in the magnitude of the risk of dying from SLE over time and geographic areas indicates the possible influence of biological, environmental, socioeconomic and health systems factors. The growing trend in SLE mortality in Cuba demands its recognition as an important health problem and immediate actions that help mitigate it. Disclosure  H. Hernández Negrín: None.

scholarly journals AB0421 EFFECT OF BODY WEIGHT ON COMPLEMENT LEVELS IN SYSTEMIC LUPUS ERYTHEMATOSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1510.3-1510
Author(s):  
L. Kondrateva ◽  
T. Popkova ◽  
E. Nasonov ◽  
A. Lila
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Normal Weight ◽  
World Health ◽  
Systemic Lupus ◽  
Obesity Status ◽  
Health Organization ◽  
The Complement System

Background:The complement system is a recognized biomarker for diagnosis or monitoring of disease activity in systemic lupus erythematosus (SLE) patients (pts). But on the other hand, it has been linked to insulin resistance and obesity in general population.Objectives:To find out whether overweight/obesity can modify C3 or C4 levels in SLE pts.Methods:A total of 92 SLE pts (83 women, 9 men, 39 [34;47] years old) were enrolled in the study. Median disease duration was 6[2;14] years, and SLE activity using SLEDAI-2K was 4[2;8]. SLE pts were treated with glucocorticoids (89%), hydroxychloroquine (78%), immunosuppressants (28%), biologics (10%). The overweight/obesity status was determined by World Health Organization criteria in patients with body mass index (BMI) ≥25kg/m2.Results:Overweight/obesity were established in 46% SLE pts. Overweight/obese SLE pts were older than pts with normal BMI (40[36;48] vs 37[31;44] years, р=0,02), and had lower SLEDAI-2K (3[2;6] vs 6[4;8], p<0,01). Lower C3 concentrations were found in 36% overweight/obese pts vs 68% pts with normal weight (р<0,01), decreased C4 levels - in 19% vs 30% pts (p=0,33), median C3 concentrations were 0,98[0,81;1,14] g/l vs 0,84[0,69;0;96] g/l (р<0,01), and C4 levels were 0,15[0,10;0,19] g/l vs 0,12[0,09;0,16] g/l, respectively (p=0,03). C3 and C4 levels negatively correlated with SLEDAI-2K (r=-0,5, p<0,01 for both), the effect was more strongly pronounced in patients with BMI≥25kg/m2 (r=-0,6, p<0,01 for both) than in those with normal weight (r=-0,2, p=0,09 for C3, r=-0,3, p=0,04 for C4).Conclusion:Overweight/obesity status in SLE pts was associated with increased levels of complement proteins, therefore decreased C3 or C4 levels in patients with BMI≥25kg/m2 are more likely related to disease activity and, can potentially induce SLE flares.Disclosure of Interests: :None declared

Serum Immunoglobulins in Systemic Lupus Erythematosus

1972 ◽  
Vol 43 (1) ◽  
pp. 121-131 ◽  
Author(s):  
D. Alarcón-Segovia ◽  
Eugenia Fishbein
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Mexico City ◽  
Lupus Erythematosus ◽  
Frequent Pattern ◽  
World Health ◽  
Inactive Disease ◽  
Systemic Lupus ◽  
Calf Thymus ◽  
Reference Preparation ◽  
Health Organization

1. Activities of the three major classes of immunoglobulins were quantitatively determined in 481 sera from 106 patients with systemic lupus erythematosus residing in Mexico City and compared with activities in 112 healthy Mexico City residents. 2. To allow comparison with studies from other laboratories, results were related to a standard reference preparation from the World Health Organization and expressed in international units of immunoglobulin activity. 3. The mean activities of IgG and IgM, but not those of IgA, were significantly higher in the lupus sera than in controls. Abnormal elevation of IgG activity was related to the presence of antibodies to whole calf thymus nuclei, but not to those directed to nucleoprotein or DNA. Sera with rheumatoid factor activity had a higher mean IgA activity than those without it. 4. Patients with active lupus had significantly higher IgM activity than those with inactive disease. High IgM activities also correlated with presence of antibodies to calf thymus nuclei, nucleoprotein and native and heat-denatured DNA. 5. Abnormal elevation of the IgM activity without concurrent elevation of IgG or IgA activity was the most frequent pattern observed but was not predominant enough to be characteristic of systemic lupus.

scholarly journals Prostate cancer mortality trends in Argentina 1986-2006: an age-period-cohort and joinpoint analysis

2011 ◽  
Vol 27 (1) ◽  
pp. 123-130 ◽  
Author(s):  
Camila Niclis ◽  
Sonia A. Pou ◽  
Rubén H. Bengió ◽  
Alberto R. Osella ◽  
María del Pilar Díaz
Keyword(s):  
Prostate Cancer ◽  
Cancer Mortality ◽  
Time Trends ◽  
World Health ◽  
Mortality Data ◽  
Birth Cohorts ◽  
Mortality Trends ◽  
Prostate Cancer Mortality ◽  
Increased Risk ◽  
Health Organization

The aim of this study was to give an overview of the magnitude, variation by age and time trends in the rates of prostate cancer mortality in Córdoba province and in Argentina as a whole from 1986 to 2006. Mortality data were provided by the Córdoba Ministry of Health and the World Health Organization cancer mortality database. Prostate cancer mortality time trends were analyzed using joinpoint analysis and age-period-cohort models. In Argentina prostate cancer age-standardized mortality rates rose by 1% and 3.4% per year from 1986 to 1992 and from 1992 to 1998 respectively. There was a decreasing trend (-1.6%) for Argentina from 1998 and Córdoba (-1.9%) from 1995. Age-period-cohort models for the country and the province showed a strong age effect. In the country there was an increased risk in the 1996-2000 period, whereas there was decreased risk for birth cohorts since 1946, principally in Córdoba. A decreasing trend in prostate cancer mortality was found in Córdoba as well as in Argentina, which might be attributed to the improvement in treatment in this country.

Ten-year Absolute Fracture Risk and Hip Bone Strength in Canadian Women with Systemic Lupus Erythematosus

2012 ◽  
Vol 39 (7) ◽  
pp. 1378-1384 ◽  
Author(s):  
JENNIFER J.Y. LEE ◽  
ELAHEH AGHDASSI ◽  
ANGELA M. CHEUNG ◽  
STACEY MORRISON ◽  
ANNE CYMET ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Fracture Risk ◽  
Lupus Erythematosus ◽  
Assessment Tool ◽  
Bone Structure ◽  
World Health ◽  
Systemic Lupus ◽  
Fracture Risk Assessment Tool ◽  
Z Scores ◽  
Health Organization

Objective.Women with systemic lupus erythematosus (SLE) are at risk of osteoporosis (OP) and fractures because of SLE or its treatments. We aimed to determine in women with SLE (1) the prevalence of low bone mass (LBM) in those < 50 years of age and OP in those > 50 years of age; (2) the 10-year absolute fracture risk in those > 40 years of age using the Canadian Fracture Risk Assessment Tool (FRAX); (3) bone quality using hip structural analysis (HSA); and (4) the associations between HSA and age, SLE duration, and corticosteroid exposure.Methods.Women without prior OP fractures were eligible. Bone mineral densities at the hip, spine, and femoral neck were determined using dual-energy x-ray absorptiometry. OP was determined using World Health Organization definitions for participants aged ≥ 50 years (32.8%), and LBM was defined as Z-scores ≤ −2.0 for those aged < 50 years. For those aged ≥ 40 years (63.5%), the 10-year probabilities of a major fracture (FRAX-Major) and hip fracture (FRAX-Hip) were calculated. FRAX-Major ≥ 20% or Hip ≥ 3% was considered high risk. HSA was done in a subgroup (n = 81) of patients.Results.The study group was 271 women. Mean (SD) age was 43.8 (13.1) years and SLE duration was 11.6 (10.4) years. OP was diagnosed in 14.6% and LBM in 8.8%. FRAX-Major ≥ 20% was seen in 9 patients (5.3%), of whom 6 were taking OP medications. FRAX-Hip ≥ 3% occurred in 16 patients (9.4%), of whom 9 were taking OP medications. Buckling ratio at the left hip narrow neck was positively correlated with FRAX-Major, FRAX-Hip, SLE duration, and duration of corticosteroid use.Conclusion.LBM is prevalent in women with SLE who are < 50 years of age. FRAX may identify those at higher risk of fractures while HSA can assess bone structure noninvasively.

scholarly journals Flares in patients with systemic lupus erythematosus

Rheumatology ◽  
2020 ◽  
Author(s):  
Kathleen McElhone ◽  
Janice Abbott ◽  
Margaret Hurley ◽  
Jane Burnell ◽  
Peter Lanyon ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Trial Design ◽  
Disease Duration ◽  
Clinical Trial Design ◽  
Reference Population ◽  
World Population ◽  
Future Clinical Trial ◽  
Systemic Lupus

Abstract Objective SLE is characterized by relapses and remissions. We aimed to describe the frequency, type and time to flare in a cohort of SLE patients. Methods SLE patients with one or more ‘A’ or ‘B’ BILAG-2004 systems meeting flare criteria (‘new’ or ‘worse’ items) and requiring an increase in immunosuppression were recruited from nine UK centres and assessed at baseline and monthly for 9 months. Subsequent flares were defined as: severe (any ‘A’ irrespective of number of ‘B’ flares), moderate (two or more ‘B’ without any ‘A’ flares) and mild (one ‘B’). Results Of the 100 patients, 94% were female, 61% White Caucasians, mean age (s.d.) was 40.7 years (12.7) and mean disease duration (s.d.) was 9.3 years (8.1). A total of 195 flares re-occurred in 76 patients over 781 monthly assessments (flare rate of 0.25/patient-month). There were 37 severe flares, 32 moderate flares and 126 mild flares. By 1 month, 22% had a mild/moderate/severe flare and 22% had a severe flare by 7 months. The median time to any ‘A’ or ‘B’ flare was 4 months. Severe/moderate flares tended to be in the system(s) affected at baseline, whereas mild flares could affect any system. Conclusion . In a population with active SLE we observed an ongoing rate of flares from early in the follow-up period with moderate–severe flares being due to an inability to fully control the disease. This real-world population study demonstrates the limitations of current treatments and provides a useful reference population from which to inform future clinical trial design.

scholarly journals Do Death Certificates Underestimate the Burden of Rare Diseases? The Example of Systemic Lupus Erythematosus Mortality, Sweden, 2001-2013

2018 ◽  
Vol 133 (4) ◽  
pp. 481-488 ◽  
Author(s):  
Titilola Falasinnu ◽  
Marios Rossides ◽  
Yashaar Chaichian ◽  
Julia F. Simard
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cause Of Death ◽  
Rare Diseases ◽  
Lupus Erythematosus ◽  
Health Resources ◽  
Premature Mortality ◽  
Population Based ◽  
Mortality Data ◽  
Systemic Lupus ◽  
Swedish Population

Objectives: Mortality due to rare diseases, which are substantial sources of premature mortality, is underreported in mortality studies. The objective of this study was to determine the completeness of reporting systemic lupus erythematosus (SLE) as a cause of death. Methods: In 2017, we linked data on a Swedish population-based cohort (the Swedish Lupus Linkage, 2001-2013) comprising people with SLE (n = 8560) and their matched general population comparators (n = 37 717) to data from the Cause of Death Register. We reviewed death records of deceased people from the cohort (n = 5110) and extracted data on patient demographic characteristics and causes of death. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for not reporting SLE as a cause of death by using multivariable-adjusted logistic regression models. Results: Of 1802 deaths among SLE patients in the study, 1071 (59%) did not have SLE reported on their death records. Most SLE decedents were aged 75-84 at death (n = 584, 32%), female (n = 1462, 81%), and born in Nordic countries (n = 1730, 96%). Decedents aged ≥85 at death were more likely to have SLE not reported on their death records than were decedents aged <50 (OR = 2.34; 95% CI, 1.48-3.68). Having renal failure listed as a cause of death decreased the likelihood of SLE not being reported on the death record (OR = 0.54; 95% CI, 0.40-0.73), whereas having cancer listed as a cause of death increased this likelihood (OR = 2.39; 95% CI, 1.85-3.07). Conclusions: SLE was greatly underreported as a cause of mortality on death records of SLE patients, particularly in older decedents and those with cancer, thereby underestimating the true burden of this disease. Public health resources need to focus on improving the recording of rare diseases in order to enhance the epidemiological utility of mortality data.

scholarly journals Undertreatment of Disease Activity in Systemic Lupus Erythematosus Patients with Endstage Renal Failure Is Associated with Increased All-cause Mortality

2011 ◽  
Vol 38 (11) ◽  
pp. 2382-2389 ◽  
Author(s):  
ANNA BRODER ◽  
SAAKSHI KHATTRI ◽  
RUCHIKA PATEL ◽  
CHAIM PUTTERMAN
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Renal Failure ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Immunosuppressive Therapy ◽  
Lupus Erythematosus ◽  
Survival Rates ◽  
Mortality Data ◽  
Systemic Lupus ◽  
Endstage Renal Failure

Objective.In a cohort of systemic lupus erythematosus (SLE) patients with endstage renal failure, to evaluate whether continuing rheumatology followup visits and immunosuppressive therapy after starting renal replacement were associated with increased survival.Methods.We identified all SLE patients over 21 years old who started renal replacement therapy between 2005 and 2011 at an urban tertiary care center. Mortality data were obtained using in-hospital records and the US Social Security Death Index database.Results.We identified 80 SLE patients undergoing renal replacement therapy. Twenty-two patients (28%) were followed in rheumatology clinics frequently (2 or more visits per year) after starting renal replacement therapy, and 58 patients (72%) were followed infrequently (fewer than 2 visits per year). Survival rates were significantly higher in transplant patients compared with dialysis patients. Patients with SLE followed frequently after starting dialysis had significantly higher 4-year survival rates compared with patients followed infrequently after starting dialysis (log-rank p = 0.03). In the Cox proportional hazards model, treatment with prednisone alone or with no medication was associated with a hazard ratio (HR) of death = 6.1 (95% CI 1.1, 34; p = 0.04) and HR = 13 (95% CI 1.5, 106; p = 0.02), respectively, compared with patients treated with a combination of immunosuppressive therapy with or without prednisone, adjusted for age at SLE diagnosis, sex, transplant status, and the frequency of rheumatology visits after the development of endstage renal failure.Conclusion.Active disease in patients with SLE undergoing renal replacement therapy may be underrecognized and undertreated, leading to increased mortality.

scholarly journals Leukemia mortality in children from Latin America: Trends and predictions to 2030

2020 ◽  
Author(s):  
J. Smith Torres-Roman ◽  
Bryan Valcarcel ◽  
Pedro Guerra-Canchari ◽  
Camila Alves Dos Santos ◽  
Isabelle Ribeiro Barbosa ◽  
...  
Keyword(s):  
Latin American ◽  
Mortality Rates ◽  
World Health ◽  
Mortality Data ◽  
Mortality Trends ◽  
Annual Percent Change ◽  
Universal Healthcare ◽  
The World ◽  
Health Organization ◽  
Universal Healthcare Coverage

Abstract Background: Reports suggest that Latin American and Caribbean (LAC) countries have not reduced in leukemia mortality compared to high-income countries. However, updated trends remain largely unknown in the region. Given that leukemia is the leading cause of cancer-related death in LAC children, we evaluated mortality trends in children (0-14y) from 15 LAC countries for the period 2000-2017 and predicted mortality to 2030.Methods: We retrieved cancer mortality data using the World Health Organization Mortality Database. Mortality rates (standardized to the world standard SEGI population) were analyzed for 15 LAC countries. We evaluated the average mortality rates for the last 5 years (2013-2017). Joinpoint regression analysis was used to evaluate leukemia mortality trends and provide an estimated annual percent change (EAPC). Nordpred was utilized for the calculation of predictions until 2030.Results: Between 2013 and 2017, the highest mortality rates were reported in Venezuela, Ecuador, Nicaragua, Mexico, and Peru. Upward mortality trends were reported in Nicaragua (EAPC by 2.9% in boys, and EAPC by 2.0% in girls), and Peru (EAPC by 1.4% in both sexes). Puerto Rico experienced large declines in mortality among both boys (EAPC by −9.7%), and girls (EAPC by −6.0%). Leukemia mortality will increase in Argentina, Ecuador, Guatemala, Panama, Peru, and Uruguay by 2030.Conclusion: Leukemia mortality is predicted to increase in some LAC countries by 2030. Interventions to prevent this outcome should be tailor to reduce the socioeconomic inequalities and ensure universal healthcare coverage.

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