Damage accrual related to pregnancies before and after diagnosis of systemic lupus erythematosus: a cross-sectional and nested case-control analysis from a lupus registry

Lupus ◽  
2020 ◽  
Vol 29 (2) ◽  
pp. 176-181
Author(s):  
M Morishita ◽  
K-E Sada ◽  
K Ohashi ◽  
Y Miyawaki ◽  
Y Asano ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Confidence Interval ◽  
Lupus Erythematosus ◽  
Odds Ratio ◽  
Case Control ◽  
Control Analysis ◽  
Systemic Lupus ◽  
Before And After ◽  
Case Control Analysis ◽  
Nested Case Control

Objective The objective of this study was to evaluate the chronic damage associated with pregnancies before and after the diagnosis of systemic lupus erythematosus (SLE). Methods Using childbearing-aged female SLE patient data registered at the Okayama and Showa University Hospitals, a nested case-control analysis was performed to investigate the relationship between pregnancy and chronic damage using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). Results Pregnancy occurred in 22 patients before and 13 patients after the diagnosis of SLE in 104 eligible patients. Live births occurred in 82% (33/40) and 50% (9/18) of the pregnancies before and after the diagnosis of SLE, respectively. After matching age and disease duration, 33 case patients with chronic damage (SDI ≥ 1) and 33 control patients without chronic damage (SDI = 0) were selected. Hypertension was more frequent in cases than in controls (48% vs. 24%, p = 0.041). Pregnancies before and after the diagnosis of SLE were comparable between cases and controls (before the diagnosis: nine case patients and eight control patients; after the diagnosis: three case patients and five control patients; p = 1.00). Even after adjusting for hypertension using multivariate analysis, the pregnancies before and after the diagnosis were not significant predictors for chronic damage (odds ratio = 1.48 (95% confidence interval 0.33–6.65)), p = 0.60 of the pregnancy before the diagnosis; odds ratio = 0.78 (95% confidence interval 0.13–4.74), p = 0.78 of the pregnancy after the diagnosis). Conclusion Pregnancies, either before or after the diagnosis of SLE, did not show any differences in chronic damage. Our results help alleviate fears regarding childbearing in female patients with SLE and their families.

scholarly journals Association of Systemic Lupus Erythematosus With Uranium Exposure in a Community Living Near a Uranium-Processing Plant: A Nested Case-Control Study

2014 ◽  
Vol 66 (11) ◽  
pp. 3105-3112 ◽  
Author(s):  
Pai-Yue Lu-Fritts ◽  
Leah C. Kottyan ◽  
Judith A. James ◽  
Changchung Xie ◽  
Jeanette M. Buckholz ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Case Control Study ◽  
Case Control ◽  
Community Living ◽  
Processing Plant ◽  
Systemic Lupus ◽  
Nested Case Control ◽  
Control Study

Induced abortions in women with systemic lupus erythematosus

Lupus ◽  
2020 ◽  
pp. 096120332097974
Author(s):  
Karel Venne ◽  
Susan Scott ◽  
Sasha Bernatsky ◽  
Evelyne Vinet
Keyword(s):  
Systemic Lupus Erythematosus ◽  
General Population ◽  
Lupus Erythematosus ◽  
Multivariable Analysis ◽  
Similar Rate ◽  
Administrative Databases ◽  
Control Analysis ◽  
Systemic Lupus ◽  
Induced Abortions ◽  
Case Control Analysis

Objectives To determine the rates of induced abortions in women with systemic lupus erythematosus (SLE) compared to women from the general population and assess disease-related predictors of induced abortion in women with SLE. Methods We identified women with SLE (15-45 years) and determined the number of induced abortions, using Quebec’s administrative databases. We calculated the standardized incidence ratio (SIR) using general population rates. We also performed a nested-case control analysis to investigate predictors of induced abortions in SLE women (such as teratogenic immunosuppressive and corticosteroid exposures). Results Among 2508 women with SLE, we observed 293 induced abortions [incidence rate of 17.1 induced abortions per 1000 person-years (95% CI 15.2, 19.2)]. There was no clear difference in the number of induced abortions among women with SLE versus women from the general population (SIR 1.10; 95% CI 0.98, 1.24). In the multivariable analysis, we did not observe higher rates of induced abortions among women exposed to teratogenic immunosuppressives [rate ratio (RR) 0.37; 95% CI 0.13, 1.07] or using corticosteroids (RR 0.67; 95% CI 0.39, 1.16). Conclusion Our findings suggest that women with SLE have a similar rate of induced abortions as compared to the general population. This raises some concerns as unplanned pregnancies in SLE women can lead to adverse maternal and fetal outcomes. Our results should prompt further research on family planning counselling in women with SLE.

Obesity increases the incidence of new-onset lupus nephritis and organ damage during follow-up in patients with systemic lupus erythematosus

Lupus ◽  
2020 ◽  
Vol 29 (6) ◽  
pp. 578-586 ◽  
Author(s):  
Ji-Hyoun Kang ◽  
Haimuzi Xu ◽  
Sung-Eun Choi ◽  
Dong-Jin Park ◽  
Jung-Kil Lee ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Confidence Interval ◽  
Lupus Erythematosus ◽  
Odds Ratio ◽  
Global Assessment ◽  
Clinical Manifestations ◽  
Organ Damage ◽  
Physician Global Assessment ◽  
Systemic Lupus

Objective This study explored the effects of obesity on clinical manifestations, disease activity and organ damage in Korean patients with systemic lupus erythematosus (SLE). Methods We assessed 393 SLE patients annually for three consecutive years based on demographic information, clinical manifestations, laboratory findings and Physician Global Assessment, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2000 and Systemic Lupus International Collaborating Clinics (SLICC) damage index (SDI) scores. Patients were grouped by body mass index (BMI): normal weight, BMI <23 kg/m2; overweight, 23 kg/m2 ≤BMI <25 kg/m2; obese, BMI ≥25 kg/m2. The impact of obesity on clinical outcomes was assessed using univariate and multivariate analyses. Results Of the 393 patients, 59 (15.0%) were obese at enrollment. They had more comorbidities compared with non-obese patients, including diabetes, hypertension, hyperlipidemia and pulmonary hypertension. Nephritis at enrollment and newly developed nephritis during follow-up were more common ( p = 0.002 and p = 0.002, respectively) and Physician Global Assessment and SDI scores were higher in these patients for three consecutive years ( p = 0.017 and p = 0.039, respectively). Multivariate analysis revealed that obesity was significantly associated with development of nephritis during follow-up (odds ratio = 26.636; 95% confidence interval, 11.370–62.399; p < 0.001) and cumulative organ damage (odds ratio = 4.096; 95% confidence interval, 2.125–7.894, p < 0.001). Conclusions The incidences of newly developed nephritis and cumulative organ damage were higher in obese SLE patients than in non-obese SLE patients.

scholarly journals The Autoimmune Disease Risk Allele of UBE2L3 in African American Patients with Systemic Lupus Erythematosus: A Recessive Effect Upon Subphenotypes

2011 ◽  
Vol 39 (1) ◽  
pp. 73-78 ◽  
Author(s):  
SANDRA AGIK ◽  
BEVERLY S. FRANEK ◽  
AKAASH A. KUMAR ◽  
MARISSA KUMABE ◽  
TAMMY O. UTSET ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
African American ◽  
Lupus Erythematosus ◽  
Risk Allele ◽  
Disease Risk ◽  
Case Control ◽  
European Ancestry ◽  
Control Analysis ◽  
Systemic Lupus ◽  
Standard Case

Objective.UBE2L3 is associated with susceptibility to systemic lupus erythematosus (SLE) and rheumatoid arthritis in European ancestry populations, and this locus has not been investigated fully in non-European populations. We studied the UBE2L3 risk allele for association with SLE, interferon-α (IFN-α), and autoantibodies in a predominantly African American SLE cohort.MethodsWe studied 395 patients with SLE and 344 controls. The UBE2L3 rs5754217 polymorphism was genotyped using Taqman primer-probe sets, and IFN-α was measured using a reporter cell assay.Results.The UBE2L3 rs5754217 T allele was strongly enriched in African American patients with anti-La antibodies as compared to controls, and a recessive model was the best fit for this association (OR 2.55, p = 0.0061). Serum IFN-α also demonstrated a recessive association with the rs5754217 genotype in African American patients, and the TT/anti-La-positive patients formed a significantly high IFN-α subgroup (p = 0.0040). Similar nonstatistically significant patterns of association were observed in the European American patients with SLE. Case-control analysis did not show large allele frequency differences, supporting the idea that this allele is most strongly associated with anti-La-positive patients.Conclusion.This pattern of recessive influence within a subgroup of patients may explain why this allele does not produce a strong signal in standard case-control studies, and subphenotypes should be included in future studies of UBE2L3. The interaction we observed between UBE2L3 genotype and autoantibodies upon serum IFN-α suggests a biological role for this locus in patients with SLE in vivo.

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