scholarly journals Integrative Therapy Combining Chinese Herbal Medicines With Conventional Treatment Reduces the Risk of Cardiovascular Disease Among Patients With Systemic Lupus Erythematosus: A Retrospective Population-Based Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Han-Hua Yu ◽  
Chia-Jung Hsieh
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cardiovascular Disease ◽  
Lupus Erythematosus ◽  
Conventional Treatment ◽  
Herbal Medicines ◽  
Population Based ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Integrative Therapy ◽  
Chinese Herbal

Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease that involves multiple systems and organs. Advanced conventional treatment does not appear to markedly reduce the risk of cardiovascular disease (CVD) among patients with SLE. Chinese medicine is a complementary and alternative medicine system, and some SLE patients in Taiwan also use Chinese herbal medicines (CHMs). Thus, we aimed to investigate whether integrative therapy combining CHMs with conventional therapy reduces the risk of CVD among patients with SLE. We performed a 12-years population-based retrospective cohort study using the “Systemic Lupus Erythematosus Health Database” of the National Health Insurance Research Database (NHIRD) in Taiwan. Patients newly diagnosed with SLE between 2004 and 2013 were divided into CHM and non-CHM groups and followed up until the end of 2015. We applied 1:1 individual matching by age, gender, and year of being newly diagnosed with SLE; accordingly, 2,751 patients were included in both CHM and non-CHM groups after matching. We applied the Cox proportional hazard regression model to determine the risk of CVD in relation to CHM use. During the follow-up period, 407 patients in the CHM group and 469 patients in the non-CHM group developed CVD, with incidence rates of 337 and 422 per 10,000 person-years, respectively. The Cox proportional hazards model demonstrated a significantly decreased risk of CVD among SLE patients using CHMs (adjusted HR: 0.83; 95% CI 0.73–0.95; p = 0.008). Further analyses of different types of CVDs also showed a significantly decreased risk of ischemic stroke in the CHM group (adjusted HR: 0.74; 95% CI 0.57–0.97; p = 0.032). Among the frequently used single herbs and polyherbal formulas, Shu-Jing-Huo-Xue-Tang was associated with a significantly decreased risk of CVD (adjusted HR: 0.76; 95% CI 0.58–0.99; p = 0.041). In conclusion, CHM use reduced the risk of CVD among patients with SLE in Taiwan. Further randomized studies may be needed to determine the definite causal relationship between CHM use and its protective effects against CVD among patients with SLE.

Abstract 05: Race and Hospitalization for Cardiovascular Disease in Patients With Systemic Lupus Erythematosus

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Meghan Angley ◽  
Tene T Lewis ◽  
Penelope P Howards ◽  
Sung Lim
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cardiovascular Disease ◽  
African Americans ◽  
Lupus Erythematosus ◽  
Survival Curve ◽  
Population Based ◽  
Systemic Lupus ◽  
Time To Event Data ◽  
Artery Disease ◽  
Stratified Analysis

Background: Patients diagnosed with systemic lupus erythematosus (SLE) are at greater risk of cardiovascular disease (CVD) and death at earlier ages than the general population, with African Americans (AA) at risk at earlier ages than non-AAs. However, the association between race and recurrent hospitalizations for CVD, which are associated with mortality, has not been explored. Methods: The Georgia Lupus Registry (GLR) is a population-based registry of individuals with SLE in 2002-2004 in Atlanta, Georgia. Both incident and prevalent cases were enrolled, and we included all cases diagnosed beginning in 2000. The GLR was matched to Georgia inpatient hospital discharge records from 2000-2013. Using ICD-9-CM codes, we identified hospitalizations classified as having coronary heart disease, peripheral artery disease, cerebrovascular disease or heart failure. The Prentice-Williams-Peterson Model with a total time scale measured from diagnosis was used to examine recurrent time to event data. We truncated the number of hospitalizations at 3 to maintain stable modeling estimates. Patients were censored at the time of death or at the end of 2013. Models were adjusted for sex and age at diagnosis. Results: A total of 556 participants in the GLR (87% female, 73% AA) had a median age at SLE diagnosis of 38 years and 27% experienced at least 1 CVD hospitalization, while 17% experienced ≥ 2. Overall, AA race was associated with recurrent hospitalizations (adjusted hazard ratio [aHR]: 1.7, 95% confidence interval [CI]: 1.2, 2.3). In an event-specific stratified analysis, the association between AA race and the hazard of recurrence became even more pronounced in later events (Event 1 aHR: 1.2, 95% CI: 1.0, 1.5; Event 2 aHR: 1.5, 95% CI: 1.2, 2.2; Event 3 aHR: 1.9, 95% CI: 1.1, 3.2). Conclusions: African-Americans with SLE were more likely to experience recurrent hospitalizations for CVD than their non-AA counterparts, suggesting that AA individuals with SLE may be more vulnerable to CV complications of SLE. Figure 1. Survival curve for 1st event

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

Lupus ◽  
2018 ◽  
Vol 27 (8) ◽  
pp. 1247-1258 ◽  
Author(s):  
N McCormick ◽  
C A Marra ◽  
M Sadatsafavi ◽  
J A Aviña-Zubieta
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Socioeconomic Status ◽  
General Population ◽  
Lupus Erythematosus ◽  
Medical Costs ◽  
Population Based ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Direct Medical Costs ◽  
The Impact

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.

Risk of Myocardial Infarction and Stroke in Newly Diagnosed Systemic Lupus Erythematosus: A General Population-Based Study

2017 ◽  
Vol 69 (6) ◽  
pp. 849-856 ◽  
Author(s):  
J. Antonio Aviña-Zubieta ◽  
Fergus To ◽  
Kateryna Vostretsova ◽  
Mary De Vera ◽  
Eric C. Sayre ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systemic Lupus Erythematosus ◽  
General Population ◽  
Lupus Erythematosus ◽  
Population Based ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Population Based Study

scholarly journals Risk of Systemic Lupus Erythematosus in Patients With Anti-phospholipid Syndrome: A Population-Based Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Hsin-Hua Chen ◽  
Ching-Heng Lin ◽  
Wen-Cheng Chao
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Population Based ◽  
Sensitivity Analyses ◽  
Research Database ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Population Based Study ◽  
Increased Risk ◽  
Anti Phospholipid Syndrome

Objective: To investigate the association between anti-phospholipid syndrome (APS) and the risk of newly diagnosed systemic lupus erythematosus (SLE).Methods: We used 2003–2013 data derived from Taiwan's National Health Insurance Research Database to conduct this nationwide, population-based. We identified AS patients newly diagnosed between 2005 to 2013 as the study group and applied age-sex matched (1:20) and propensity score-matched (PSM) (1:2) non-SLE individuals as controls. The association between APS and risk of incident SLE was determined by calculating hazard ratios (HRs) with 95% confidence intervals (CIs) using Cox proportional hazard regression analysis.Results: We identified 1,245 patients with APS as well as 24,900 age- and sex-matched non-APS controls and 727 APS patients as well as 1,454 PSM non-APS controls. We found that the risk for incident SLE in the APS group was 80.70 times higher than the non-APS group, and the association remained robust after PSM (HR, 28.55; 95% CI, 11.49–70.91). The increased risk for SLE in patients with APS mainly existed within 5 years after the diagnosis of APS. The sensitivity analyses found that the risk for SLE in patients with APS was consistent excluding patients with ITP/AIHA and using distinct definitions of SLE.Conclusion: The present population-based study revealed a robust association between SLE risk and recent APS and highlights the need for vigilance of SLE-associated symptoms in patients who had been diagnosed with APS.

Clinical case of lung lesions in patient with newly diagnosed systemic lupus erythematosus

2019 ◽  
Vol 1 (9) ◽  
pp. 53-57
Author(s):  
T. N. Gavva ◽  
L. V. Kuzmenkova ◽  
Yu. N. Fedulaev ◽  
T. V. Pinchuk ◽  
D. D. Kaminer ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Lung Damage ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Lung Lesions ◽  
Laboratory Parameters ◽  
Clinical Interest

A case of lung damage in systemic lupus erythematosus (SLE) in a 33-year-old woman is described. This case is of clinical interest due to the complexity of diagnosis due to the fact that SLE is a disease with diverse clinical manifestations involving many organs and systems, which often makes it difficult to timely recognize the onset of the disease. SLE still remains a challenge and requires special attention to the patient s history, clinical and laboratory parameters of the patient, as well as specific immunological examinations.

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