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Type: Artigo
Title: Factors predictive of serious infections over time in systemic lupus erythematosus patients : data from a multi-ethnic, multi-national, latin american lupus cohort
Author: Pimentel-Quiroz, VR
Ugarte-Gil, MF
Harvey, GB
Wojdyla, D
Pons-Estel, GJ
Quintana, R
Esposto, A
García, MA
Catoggio, LJ
Cardiel, MH
Barile, LA
Amigo, M-C
Sato, EI
Bonfa, E
Borba, E
Costallat, LT Lavras
Neira, OJ
Massardo, L
Guibert-Toledano, M
Chacón-Díaz, R
Alarcón, GS
Pons-Estel, BA
Abstract: The aim of this study was to identify factors predictive of serious infections over time in patients with systemic lupus erythematosus (SLE). A multi-ethnic, multi-national Latin American SLE cohort was studied. Serious infection was defined as one that required hospitalization, occurred during a hospitalization or led to death. Potential predictors included were sociodemographic factors, clinical manifestations (per organ involved, lymphopenia and leukopenia, independently) and previous infections at baseline. Disease activity (SLEDAI), damage (SLICC/ACR Damage Index), non-serious infections, glucocorticoids, antimalarials (users and non-users), and immunosuppressive drugs use; the last six variables were examined as time-dependent covariates. Cox regression models were used to evaluate the predictors of serious infections using a backward elimination procedure. Univariable and multivariable analyses were performed. Of the 1243 patients included, 1116 (89.8%) were female. The median (interquartile range) age at diagnosis and follow-up time were 27 (20–37) years and 47.8 (17.9–68.6) months, respectively. The incidence rate of serious infections was 3.8 cases per 100 person-years. Antimalarial use (hazard ratio: 0.69; 95% confidence interval (CI): 0.48–0.99; p = 0.0440) was protective, while doses of prednisone >15 and ≤60 mg/day (hazard ratio: 4.18; 95 %CI: 1.69–10.31; p = 0.0019) and >60 mg/day (hazard ratio: 4.71; 95% CI: 1.35–16.49; p = 0.0153), use of methylprednisolone pulses (hazard ratio: 1.53; 95% CI: 1.10–2.13; p = 0.0124), increase in disease activity (hazard ratio: 1.03; 95% CI: 1.01–1.04; p = 0.0016) and damage accrual (hazard ratio: 1.22; 95% CI: 1.11–1.34; p < 0.0001) were predictive factors of serious infections. Over time, prednisone doses higher than 15 mg/day, use of methylprednisolone pulses, increase in disease activity and damage accrual were predictive of infections, whereas antimalarial use was protective against them in SLE patients
Subject: Lúpus eritematoso sistêmico
Country: Reino Unido
Editor: Sage
Rights: Fechado
Identifier DOI: 10.1177/0961203319860579
Date Issue: Aug-2019
Appears in Collections:FCM - Artigos e Outros Documentos

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