RT Journal Article
SR Electronic
T1 Independent association of glucocorticoids with damage accrual in SLE
JF Lupus Science & Medicine
FD Lupus Foundation of America
SP e000157
DO 10.1136/lupus-2016-000157
VO 3
IS 1
A1 Diane Apostolopoulos
A1 Rangi Kandane-Rathnayake
A1 Sudha Raghunath
A1 Alberta Hoi
A1 Mandana Nikpour
A1 Eric F Morand
YR 2016
UL http://lupus.bmj.com/content/3/1/e000157.abstract
AB Objectives To determine factors associated with damage accrual in a prospective cohort of patients with SLE.Methods Patients with SLE who attended the Lupus Clinic at Monash Health, Australia, between 2007 and 2013 were studied. Clinical variables included disease activity (Systemic Lupus Erythematosus Disease Activity Index-2K, SLEDAI-2K), time-adjusted mean SLEDAI, cumulative glucocorticoid dose and organ damage (Systemic Lupus International Collaborating Clinics Damage Index (SDI)). Multivariate logistic regression analyses were performed to identify factors associated with damage accrual.Results A total of 162 patients were observed over a median (IQR) 3.6 (2.0–4.7) years. Seventy-five per cent (n=121) of patients received glucocorticoids. Damage accrual was significantly more frequent in glucocorticoid-exposed patients (42% vs 15%, p<0.01). Higher glucocorticoid exposure was independently associated with overall damage accrual after controlling for factors including ethnicity and disease activity and was significant at time-adjusted mean doses above 4.42 mg prednisolone/day; the OR of damage accrual in patients in the highest quartile of cumulative glucocorticoid exposure was over 10. Glucocorticoid exposure was independently associated with damage accrual in glucocorticoid-related and non-glucocorticoid related domains of the SDI.Conclusions Glucocorticoid use is independently associated with the accrual of damage in SLE, including in non-glucocorticoid related domains.