Association Between Severe Nonadherence to Hydroxychloroquine and Systemic Lupus Erythematosus Flares, Damage, and Mortality in 660 Patients From the SLICC Inception Cohort.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Nguyen Yann, Blanchet Benoît, Urowitz Murray B, Hanly John G, Gordon Caroline, Bae Sang-Cheol, Romero-Diaz Juanita, Sanchez-Guerrero Jorge, Clarke Ann E, Bernatsky Sasha, Wallace Daniel J, Isenberg David A, Rahman Anisur, Merrill Joan T, Fortin Paul R, Gladman Dafna D, Bruce Ian N, Petri Michelle, Ginzler Ellen M, Dooley Mary Anne, Ramsey-Goldman Rosalind, Manzi Susan, Jönsen Andreas, Alarcón Graciela S, Van Vollenhoven Ronald F, Aranow Cynthia, Le Guern Véronique, Mackay Meggan, Ruiz-Irastorza Guillermo, Lim S Sam, Inanc Murat, Kalunian Kenneth C, Jacobsen Søren, Peschken Christine A, Kamen Diane L, Askanase Anca, Buyon Jill, Costedoat-Chalumeau Nathalie
Аннотация
METHODS: The Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort is an international multicenter initiative (33 centers throughout 11 countries). The serum of patients prescribed HCQ for at least three months at enrollment were analyzed. Severe nonadherence was defined by a serum HCQ level <106 ng/mL or <53 ng/mL for HCQ doses of 400 or 200 mg/day, respectively. Associations with the risk of a flare (defined as a Systemic Lupus Erythematosus Disease Activity Index 2000 increase ≥4 points, initiation of prednisone or immunosuppressive drugs, or new renal involvement) were studied with logistic regression, and associations with damage (first SLICC/American College of Rheumatology Damage Index [SDI] increase ≥1 point) and mortality with separate Cox proportional hazard models.
RESULTS: Of the 1,849 cohort participants, 660 patients (88% women) were included. Median (interquartile range) serum HCQ was 388 ng/mL (244-566); 48 patients (7.3%) had severe HCQ nonadherence. No covariates were clearly associated with severe nonadherence, which was, however, independently associated with both flare (odds ratio 3.38; 95% confidence interval [CI] 1.80-6.42) and an increase in the SDI within each of the first three years (hazard ratio [HR] 1.92 at three years; 95% CI 1.05-3.50). Eleven patients died within five years, including 3 with severe nonadherence (crude HR 5.41; 95% CI 1.43-20.39).
CONCLUSION: Severe nonadherence was independently associated with the risks of an SLE flare in the following year, early damage, and five-year mortality.