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Factors predictive of serious infections over time in systemic lupus erythematosus patients: data from a multi-ethnic, multi-national, Latin American lupus cohort

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dc.contributor.author Pimentel-Quiroz, V. R.
dc.contributor.author Ugarte-Gil, M. F.
dc.contributor.author Harvey, G. B.
dc.contributor.author Wojdyla, D.
dc.contributor.author Pons-Estel, G. J.
dc.contributor.author Quintana, R.
dc.contributor.author Esposto, A.
dc.contributor.author Garcia, M. A.
dc.contributor.author Catoggio, L. J.
dc.contributor.author Cardiel, M. H.
dc.contributor.author Barile, L. A.
dc.contributor.author Amigo, M.-C.
dc.contributor.author Sato, E. I.
dc.contributor.author Bonfa, E.
dc.contributor.author Borba, E.
dc.contributor.author Lavras Costallat, L. T.
dc.contributor.author Neira, O. J.
dc.contributor.author Massardo, L.
dc.contributor.author Guibert-Toledano, M.
dc.contributor.author Chacon-Diaz, R.
dc.contributor.author Alarcon, G. S.
dc.contributor.author Pons-Estel, B. A.
dc.date.accessioned 2019-12-06T21:02:52Z
dc.date.available 2019-12-06T21:02:52Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/7460
dc.description.abstract AIM: The aim of this study was to identify factors predictive of serious infections over time in patients with systemic lupus erythematosus (SLE). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. en_US
dc.language.iso eng
dc.publisher SAGE Publications
dc.relation.ispartof urn:issn:1477-0962
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject adult en_US
dc.subject antimalarial agent en_US
dc.subject antimalarial use en_US
dc.subject Article en_US
dc.subject azathioprine en_US
dc.subject central nervous system infection en_US
dc.subject cohort analysis en_US
dc.subject controlled study en_US
dc.subject cyclophosphamide en_US
dc.subject disease activity en_US
dc.subject ethnicity en_US
dc.subject female en_US
dc.subject follow up en_US
dc.subject glucocorticoid en_US
dc.subject glucocorticoid use en_US
dc.subject hospitalization en_US
dc.subject human en_US
dc.subject hydroxychloroquine en_US
dc.subject incidence en_US
dc.subject infection en_US
dc.subject leukopenia en_US
dc.subject lower respiratory tract infection en_US
dc.subject lymphocytopenia en_US
dc.subject major clinical study en_US
dc.subject male en_US
dc.subject marriage en_US
dc.subject methylprednisolone en_US
dc.subject predictive value en_US
dc.subject prednisone en_US
dc.subject priority journal en_US
dc.subject serious infections en_US
dc.subject skin infection en_US
dc.subject SLEDAI en_US
dc.subject social status en_US
dc.subject systemic lupus erythematosus en_US
dc.subject Systemic lupus erythematosus en_US
dc.subject urinary tract infection en_US
dc.title Factors predictive of serious infections over time in systemic lupus erythematosus patients: data from a multi-ethnic, multi-national, Latin American lupus cohort en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1177/0961203319860579
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE


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