RT Journal Article
SR Electronic
T1 First month prednisone dose predicts prednisone burden during the following 11 months: an observational study from the RELES cohort
JF Lupus Science & Medicine
FD Lupus Foundation of America
SP e000153
DO 10.1136/lupus-2016-000153
VO 3
IS 1
A1 Ruiz-Irastorza, G
A1 Garcia, M
A1 Espinosa, G
A1 Caminal, L
A1 Mitjavila, F
A1 González-León, R
A1 Sopeña, B
A1 Canora, J
A1 Villalba, M V
A1 Rodríguez-Carballeira, M
A1 López-Dupla, J M
A1 Callejas, J L
A1 Castro, A
A1 Tolosa, C
A1 Sánchez-García, M E
A1 Pérez-Conesa, M
A1 Navarrete-Navarrete, N
A1 Rodríguez, A P
A1 Herranz, M T
A1 Pallarés, L
YR 2016
UL http://lupus.bmj.com/content/3/1/e000153.abstract
AB Aim To study the influence of prednisone dose during the first month after systemic lupus erythematosus (SLE) diagnosis (prednisone-1) on glucocorticoid burden during the subsequent 11 months (prednisone-2–12).Methods 223 patients from the Registro Español de Lupus Eritematoso Sistémico inception cohort were studied. The cumulative dose of prednisone-1 and prednisone-2–12 were calculated and recoded into a four-level categorical variable: no prednisone, low dose (up to 7.5 mg/day), medium dose (up to 30 mg/day) and high dose (over 30 mg/day). The association between the cumulative prednisone-1 and prednisone-2–12 doses was tested. We analysed whether the four-level prednisone-1 categorical variable was an independent predictor of an average dose >7.5 mg/day of prednisone-2–12. Adjusting variables included age, immunosuppressives, antimalarials, methyl-prednisolone pulses, lupus nephritis and baseline SLE Disease Activity Index (SLEDAI).Results Within the first month, 113 patients (51%) did not receive any prednisone, 24 patients (11%) received average low doses, 46 patients (21%) received medium doses and 40 patients (18%) received high doses. There was a strong association between prednisone-1 and prednisone-2–12 dose categories (p<0.001). The cumulative prednisone-1 dose was directly associated with the cumulative prednisone-2–12 dose (p<0.001). Compared with patients on no prednisone, patients taking medium (adjusted OR 5.27, 95% CI 2.18 to 12.73) or high-dose prednisone-1 (adjusted OR 10.5, 95% CI 3.8 to 29.17) were more likely to receive prednisone-2–12 doses of >7.5 mg/day, while patients receiving low-dose prednisone-1 were not (adjusted OR 1.4, 95% CI 0. 0.38 to 5.2). If the analysis was restricted to the 158 patients with a baseline SLEDAI of ≥6, the model did not change.Conclusion The dose of prednisone during the first month after the diagnosis of SLE is an independent predictor of prednisone burden during the following 11 months.