Victor R Pimentel-Quiroz1, Manuel F Ugarte-Gil2, Guillermo J Pons-Estel3, Enrique R Soriano4, Verónica Saurit5, Emilia I Sato6, Lilian T Lavras Costallat7, José Fernando Molina8, Antonio Iglesias-Gamarra9, Gil Reyes-Llerena10, Oscar J Neira11, Leonor A Barile12, Luis H Silveira13, María Ines Segami14, Rosa Chacón-Díaz15, Daniel Wojdyla16, Graciela S Alarcón17, Bernardo A Pons-Estel18. 1. Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Av. Grau 800, La Victoria, Lima 13, Lima, Peru. Electronic address: victorpq4@gmail.com. 2. Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Av. Grau 800, La Victoria, Lima 13, Lima, Peru; Universidad Científica del Sur, Lima, Peru. 3. Department of Autoimmune Diseases, Institut Clínic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Spain. 4. Sección de Reumatología, Servicio de Clínica Médica, Hospital Italiano and Fundación Dr. Pedro M. Catoggio para el Progreso de la Reumatología, Buenos Aires, Argentina. 5. Servicio de Reumatología, Hospital Privado, Centro Medico de Córdoba, Córdoba, Argentina. 6. Departamento de Medicina, Disciplina de Reumatología, Escola Paulista de Medicina, Universidade Federal da São Paulo-UNIFESP, São Paulo, Brazil. 7. Disciplina de Reumatología, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas-UNICAMP, Campinas, Brazil. 8. Reumalab, Centro Integral de Reumatología, Medellín, Colombia. 9. Departamento de Medicina, Universidad del Bosque, Bogotá, Colombia. 10. Servicio de Reumatología, Centro de Investigaciones Médico Quirúrgicas-CIMEQ, Havana, Cuba. 11. Servicio de Reumatología, Hospital del Salvador, Facultad de Medicina, Universidad de Chile, Santiago, Chile. 12. Servicio de Reumatología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico. 13. Departamento de Reumatología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de Mexico, Mexico. 14. Servicio de Reumatología, Hospital Nacional Edgardo Rebagliatti Martins, Essalud, Lima, Peru. 15. Servicio de Reumatología, Centro Nacional de Enfermedades Reumáticas, Hospital Universitario de Caracas, Caracas, Venezuela. 16. Department of Statistic, Associated to GLADEL, Rosario, Argentina. 17. Department of Medicine, Division of Clinical Immunology and Rheumatology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL. 18. Servicio de Reumatología, Hospital Provincial de Rosario, Rosario, Argentina.
Abstract
AIMS: To determine the factors predictive of disease activity early in the course of SLE (baseline visit). METHODS: Patients from GLADEL, a multi-national, multi-ethnic, Latin-American lupus cohort were included. Disease activity was evaluated at baseline with the SLEDAI score. Demographic characteristics (age at diagnosis, gender, ethnicity, marital status, educational level, medical coverage and socioeconomic status) were assessed. Disease duration was defined as the time between the fourth ACR criterion and baseline. Time to criteria accrual was defined as the interval between the first and fourth ACR criterion. Use of glucocorticoids was recorded as the highest dose received before the baseline visit. Antimalarials and immunosuppressive drugs were recorded as use or not use. Univariable and multivariable analysis were performed. Model selection was based on backward elimination. RESULTS: One thousand two hundred sixty-eight patients were included; 1136 (89.6%) of them were female. Mean age at diagnosis was 29.2 (SD: 12.3) years. Five hundred sixty-five (44.6%) were Mestizo, 539 (42.5%) were Caucasians and 164 (12.9%) were African-Latin-Americans. The mean SLEDAI at baseline was 10.9 (SD: 8.4). Longer time between first and fourth ACR criterion, medical coverage, a dose of prednisone between 15 and 60mg/d, and the use of antimalarials were factors protective of disease activity, while Mestizo and African-Latin-American ethnicities were predictive factors. CONCLUSIONS: Mestizo and African-Latin-American ethnicities were predictive whereas antimalarial use, medical coverage, and longer time to criteria accrual were protective of higher disease activity early in the disease course.
AIMS: To determine the factors predictive of disease activity early in the course of SLE (baseline visit). METHODS:Patients from GLADEL, a multi-national, multi-ethnic, Latin-American lupus cohort were included. Disease activity was evaluated at baseline with the SLEDAI score. Demographic characteristics (age at diagnosis, gender, ethnicity, marital status, educational level, medical coverage and socioeconomic status) were assessed. Disease duration was defined as the time between the fourth ACR criterion and baseline. Time to criteria accrual was defined as the interval between the first and fourth ACR criterion. Use of glucocorticoids was recorded as the highest dose received before the baseline visit. Antimalarials and immunosuppressive drugs were recorded as use or not use. Univariable and multivariable analysis were performed. Model selection was based on backward elimination. RESULTS: One thousand two hundred sixty-eight patients were included; 1136 (89.6%) of them were female. Mean age at diagnosis was 29.2 (SD: 12.3) years. Five hundred sixty-five (44.6%) were Mestizo, 539 (42.5%) were Caucasians and 164 (12.9%) were African-Latin-Americans. The mean SLEDAI at baseline was 10.9 (SD: 8.4). Longer time between first and fourth ACR criterion, medical coverage, a dose of prednisone between 15 and 60mg/d, and the use of antimalarials were factors protective of disease activity, while Mestizo and African-Latin-American ethnicities were predictive factors. CONCLUSIONS: Mestizo and African-Latin-American ethnicities were predictive whereas antimalarial use, medical coverage, and longer time to criteria accrual were protective of higher disease activity early in the disease course.
Authors: Elizabeth R Graef; Jean W Liew; Alfred Hj Kim; Jeffrey A Sparks; Michael S Putman; Julia F Simard; Emily Sirotich; Francis Berenbaum; Alí Duarte-García; Rebecca Grainger; Carly Harrison; Maximilian F Konig; Peter Korsten; Laurie Proulx; Dawn P Richards; Philip C Robinson; Sebastian E Sattui; Manuel Francisco Ugarte-Gil; Kristen J Young Journal: Ann Rheum Dis Date: 2020-04-15 Impact factor: 27.973
Authors: Bernardo A Pons-Estel; Eloisa Bonfa; Enrique R Soriano; Mario H Cardiel; Ariel Izcovich; Federico Popoff; Juan M Criniti; Gloria Vásquez; Loreto Massardo; Margarita Duarte; Leonor A Barile-Fabris; Mercedes A García; Mary-Carmen Amigo; Graciela Espada; Luis J Catoggio; Emilia Inoue Sato; Roger A Levy; Eduardo M Acevedo Vásquez; Rosa Chacón-Díaz; Claudio M Galarza-Maldonado; Antonio J Iglesias Gamarra; José Fernando Molina; Oscar Neira; Clóvis A Silva; Andrea Vargas Peña; José A Gómez-Puerta; Marina Scolnik; Guillermo J Pons-Estel; Michelle R Ugolini-Lopes; Verónica Savio; Cristina Drenkard; Alejandro J Alvarellos; Manuel F Ugarte-Gil; Alejandra Babini; André Cavalcanti; Fernanda Athayde Cardoso Linhares; Maria Jezabel Haye Salinas; Yurilis J Fuentes-Silva; Ana Carolina Montandon de Oliveira E Silva; Ruth M Eraso Garnica; Sebastián Herrera Uribe; Diana Gómez-Martín; Ricardo Robaina Sevrini; Rosana M Quintana; Sergio Gordon; Hilda Fragoso-Loyo; Violeta Rosario; Verónica Saurit; Simone Appenzeller; Edgard Torres Dos Reis Neto; Jorge Cieza; Luis A González Naranjo; Yelitza C González Bello; María Victoria Collado; Judith Sarano; Soledad Retamozo; María E Sattler; Rocio V Gamboa-Cárdenas; Ernesto Cairoli; Silvana M Conti; Luis M Amezcua-Guerra; Luis H Silveira; Eduardo F Borba; Mariana A Pera; Paula B Alba Moreyra; Valeria Arturi; Guillermo A Berbotto; Cristian Gerling; Carla A Gobbi; Viviana L Gervasoni; Hugo R Scherbarth; João C Tavares Brenol; Fernando Cavalcanti; Lilian T Lavras Costallat; Nilzio A Da Silva; Odirlei A Monticielo; Luciana Parente Costa Seguro; Ricardo M Xavier; Carolina Llanos; Rubén A Montúfar Guardado; Ignacio Garcia de la Torre; Carlos Pineda; Margarita Portela Hernández; Alvaro Danza; Marlene Guibert-Toledano; Gil Llerena Reyes; Maria Isabel Acosta Colman; Alicia M Aquino; Claudia S Mora-Trujillo; Roberto Muñoz-Louis; Ignacio García Valladares; María Celeste Orozco; Paula I Burgos; Graciela V Betancur; Graciela S Alarcón Journal: Ann Rheum Dis Date: 2018-07-25 Impact factor: 19.103