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|Title:||Predictive factors of flares in systemic lupus erythematosus patients: data from a multiethnic Latin American cohort|
|Authors:||Ugarte-Gil, M. F.|
Pastor-Asurza, C. A.
Gamboa-Cardenas, R. V.
Acevedo-Vasquez, E. M.
Catoggio, L. J.
Garcia, M. A.
Sato, Emilia Inoue [UNIFESP]
Barile, L. A.
Molina-Restrepo, J. F.
Alarcon, G. S.
Pons-Estel, B. A.
|Keywords:||Systemic lupus erythematosus|
|Publisher:||Sage Publications Ltd|
|Citation:||Lupus. London, v. 27, n. 4, p. 536-544, 2018.|
|Abstract:||Purpose The purpose of this paper is to determine the factors predictive of flares in systemic lupus erythematosus (SLE) patients. Methods A case-control study nested within the Grupo Latino Americano De Estudio de Lupus (GLADEL) cohort was conducted. Flare was defined as an increase 4 points in the SLEDAI. Cases were defined as patients with at least one flare. Controls were selected by matching cases by length of follow-up. Demographic and clinical manifestations were systematically recorded by a common protocol. Glucocorticoid use was recorded as average daily dose of prednisone and antimalarial use as percentage of time on antimalarial and categorized as never (0%), rarely (>0-25%), occasionally (>25%-50%), commonly (?50%-75%) and frequently (?75%). Immunosuppressive drugs were recorded as used or not used. The association between demographic, clinical manifestations, therapy and flares was examined using univariable and multivariable conditional logistic regression models. Results A total of 465 cases and controls were included. Mean age at diagnosis among cases and controls was 27.5 vs 29.9 years, p=0.003|
gender and ethnic distributions were comparable among both groups and so was the baseline SLEDAI. Independent factors protective of flares identified by multivariable analysis were older age at diagnosis (OR=0.929 per every five years, 95% CI 0.869-0.975
p=0.004) and antimalarial use (frequently vs never, OR=0.722, 95% CI 0.522-0.998
p=0.049) whereas azathioprine use (OR=1.820, 95% CI 1.309-2.531
p<0.001) and SLEDAI post-baseline were predictive of them (OR=1.034, 95% CI 1.005-1.064
p=0.022). Conclusions In this large, longitudinal Latin American cohort, older age at diagnosis and more frequent antimalarial use were protective whereas azathioprine use and higher disease activity were predictive of flares.
|Appears in Collections:||Artigo|
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