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Association of one-point glucocorticoid-free status with chronic damage and disease duration in systemic lupus erythematosus: a cross-sectional study
OBJECTIVE: It is still unclear how glucocorticoids (GCs) affect the long-term clinical course of patients with SLE. The objective of this study is to explore the factors associated with GC-free treatment status. METHODS: Using data from the lupus registry of nationwide institutions, GC dose at regis...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9516281/ https://www.ncbi.nlm.nih.gov/pubmed/36167483 http://dx.doi.org/10.1136/lupus-2022-000772 |
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author | Sada, Ken-ei Katayama, Yu Asano, Yosuke Hayashi, Keigo Miyawaki, Yoshia Ohashi, Keiji Katsuyama, Eri Katsuyama, Takayuki Takano-Narazaki, Mariko Matsumoto, Yoshinori Yoshimi, Ryusuke Shimojima, Yasuhiro Ohno, Shigeru Kajiyama, Hiroshi Ichinose, Kunihiro Sato, Shuzo Fujiwara, Michio Yajima, Nobuyuki |
author_facet | Sada, Ken-ei Katayama, Yu Asano, Yosuke Hayashi, Keigo Miyawaki, Yoshia Ohashi, Keiji Katsuyama, Eri Katsuyama, Takayuki Takano-Narazaki, Mariko Matsumoto, Yoshinori Yoshimi, Ryusuke Shimojima, Yasuhiro Ohno, Shigeru Kajiyama, Hiroshi Ichinose, Kunihiro Sato, Shuzo Fujiwara, Michio Yajima, Nobuyuki |
author_sort | Sada, Ken-ei |
collection | PubMed |
description | OBJECTIVE: It is still unclear how glucocorticoids (GCs) affect the long-term clinical course of patients with SLE. The objective of this study is to explore the factors associated with GC-free treatment status. METHODS: Using data from the lupus registry of nationwide institutions, GC dose at registration was compared between short, middle and long disease durations of <5, 5–20 and ≥20 years, respectively. After excluding patients who never used GC, we evaluated the relationship between GC-free status and chronic damage using Systemic Lupus International Collaborating Clinics Damage Index. RESULTS: GC doses at enrolment of the 1019 patients were as follows: GC-free in 101 (10%); 0<prednisolone (PSL) ≤5 mg/day in 411 (40%); 5<PSL ≤7.5 in 169 (17%); 7.5<PSL ≤10 in 194 (19%) and PSL≥10 in 144 (14%) patients. Of the patients who were not currently using GCs, patients who never used GC more frequently had short disease duration (66% with short, 23% with middle and 17% with long disease duration, p=0.00029). Univariate analysis of patients who underwent GC treatment showed that patients without GCs exhibited older age, lower disease activity, less immunosuppressant and hydroxychloroquine use and higher C3 levels. Among patients with a disease duration of ≥20 years, GC-free status was more frequent in patients without chronic damage (11% vs 4%, p=0.023). After adjusting for age, sex and disease activity, no chronic damage accrual was associated with GC-free status (OR 3.6, 95% CI 1.1 to 11.3). CONCLUSION: Even in the patients with long disease duration, one-point GC-free treatment status might be related to no chronic damage accrual. |
format | Online Article Text |
id | pubmed-9516281 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-95162812022-09-29 Association of one-point glucocorticoid-free status with chronic damage and disease duration in systemic lupus erythematosus: a cross-sectional study Sada, Ken-ei Katayama, Yu Asano, Yosuke Hayashi, Keigo Miyawaki, Yoshia Ohashi, Keiji Katsuyama, Eri Katsuyama, Takayuki Takano-Narazaki, Mariko Matsumoto, Yoshinori Yoshimi, Ryusuke Shimojima, Yasuhiro Ohno, Shigeru Kajiyama, Hiroshi Ichinose, Kunihiro Sato, Shuzo Fujiwara, Michio Yajima, Nobuyuki Lupus Sci Med Epidemiology and Outcomes OBJECTIVE: It is still unclear how glucocorticoids (GCs) affect the long-term clinical course of patients with SLE. The objective of this study is to explore the factors associated with GC-free treatment status. METHODS: Using data from the lupus registry of nationwide institutions, GC dose at registration was compared between short, middle and long disease durations of <5, 5–20 and ≥20 years, respectively. After excluding patients who never used GC, we evaluated the relationship between GC-free status and chronic damage using Systemic Lupus International Collaborating Clinics Damage Index. RESULTS: GC doses at enrolment of the 1019 patients were as follows: GC-free in 101 (10%); 0<prednisolone (PSL) ≤5 mg/day in 411 (40%); 5<PSL ≤7.5 in 169 (17%); 7.5<PSL ≤10 in 194 (19%) and PSL≥10 in 144 (14%) patients. Of the patients who were not currently using GCs, patients who never used GC more frequently had short disease duration (66% with short, 23% with middle and 17% with long disease duration, p=0.00029). Univariate analysis of patients who underwent GC treatment showed that patients without GCs exhibited older age, lower disease activity, less immunosuppressant and hydroxychloroquine use and higher C3 levels. Among patients with a disease duration of ≥20 years, GC-free status was more frequent in patients without chronic damage (11% vs 4%, p=0.023). After adjusting for age, sex and disease activity, no chronic damage accrual was associated with GC-free status (OR 3.6, 95% CI 1.1 to 11.3). CONCLUSION: Even in the patients with long disease duration, one-point GC-free treatment status might be related to no chronic damage accrual. BMJ Publishing Group 2022-09-27 /pmc/articles/PMC9516281/ /pubmed/36167483 http://dx.doi.org/10.1136/lupus-2022-000772 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Epidemiology and Outcomes Sada, Ken-ei Katayama, Yu Asano, Yosuke Hayashi, Keigo Miyawaki, Yoshia Ohashi, Keiji Katsuyama, Eri Katsuyama, Takayuki Takano-Narazaki, Mariko Matsumoto, Yoshinori Yoshimi, Ryusuke Shimojima, Yasuhiro Ohno, Shigeru Kajiyama, Hiroshi Ichinose, Kunihiro Sato, Shuzo Fujiwara, Michio Yajima, Nobuyuki Association of one-point glucocorticoid-free status with chronic damage and disease duration in systemic lupus erythematosus: a cross-sectional study |
title | Association of one-point glucocorticoid-free status with chronic damage and disease duration in systemic lupus erythematosus: a cross-sectional study |
title_full | Association of one-point glucocorticoid-free status with chronic damage and disease duration in systemic lupus erythematosus: a cross-sectional study |
title_fullStr | Association of one-point glucocorticoid-free status with chronic damage and disease duration in systemic lupus erythematosus: a cross-sectional study |
title_full_unstemmed | Association of one-point glucocorticoid-free status with chronic damage and disease duration in systemic lupus erythematosus: a cross-sectional study |
title_short | Association of one-point glucocorticoid-free status with chronic damage and disease duration in systemic lupus erythematosus: a cross-sectional study |
title_sort | association of one-point glucocorticoid-free status with chronic damage and disease duration in systemic lupus erythematosus: a cross-sectional study |
topic | Epidemiology and Outcomes |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9516281/ https://www.ncbi.nlm.nih.gov/pubmed/36167483 http://dx.doi.org/10.1136/lupus-2022-000772 |
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