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1. Mood Disorders in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study

Author

Hanly, John G., Su, Li, Urowitz, Murray B., Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Bernatsky, Sasha, Clarke, Ann E., Wallace, Daniel J., Merrill, Joan T., Isenberg, David A., Rahman, Anisur, Ginzler, Ellen M., Petri, Michelle, Bruce, Ian N., Dooley, M. A., Fortin, Paul, Gladman, Dafna D., Sanchez-Guerrero, Jorge, Steinsson, Kristjan, Ramsey-Goldman, Rosalind, Khamashta, Munther A., Aranow, Cynthia, Alarcón, Graciela S., Fessler, Barri J., Manzi, Susan, Nived, Ola, Sturfelt, Gunnar K., Zoma, Asad A., van Vollenhoven, Ronald F., Ramos-Casals, Manuel, Ruiz-Irastorza, Guillermo, Lim, S. Sam, Kalunian, Kenneth C., Inanc, Murat, Kamen, Diane L., Peschken, Christine A., Jacobsen, Soren, Askanase, Anca, Theriault, Chris, Thompson, Kara, Farewell, Vernon, Su, Li [0000-0003-0919-3462], Farewell, Vernon [0000-0001-6704-5295], and Apollo - University of Cambridge Repository

Subjects
Adult, Male, Internationality, Mood Disorders, Incidence, Black People, Hispanic or Latino, Middle Aged, Article, White People, Cohort Studies, Asian People, Disease Progression, Quality of Life, Humans, Lupus Erythematosus, Systemic, Regression Analysis, Female, Prospective Studies, Autoantibodies
Abstract

OBJECTIVE: To examine the frequency, characteristics, and outcome of mood disorders, as well as clinical and autoantibody associations, in a multiethnic/racial, prospective inception cohort of patients with systemic lupus erythematosus (SLE). METHODS: Patients were assessed annually for mood disorders (4 types, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and 18 other neuropsychiatric events. Global disease activity scores (SLE Disease Activity Index 2000 [SLEDAI-2K]), damage scores (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI]), and Short Form 36 subscales, mental and physical component summary scores were collected. Time to event, linear and ordinal regressions, and multi-state models were used as appropriate. RESULTS: Among the 1,827 patients with SLE, 88.9% were female, and 48.9% were Caucasian. The mean ± SD age of the patients was 35.1 ± 13.3 years, disease duration was 5.6 ± 4.8 months, and the length of followup was 4.7 ± 3.5 years. During the course of the study, 863 (47.2%) of the 1,827 patients had 1,627 neuropsychiatric events. Mood disorders occurred in 232 (12.7%) of 1,827 patients, and 98 (38.3%) of 256 mood disorder events were attributed to SLE. The estimated cumulative incidence of any mood disorder after 10 years was 17.7% (95% confidence interval 15.1, 20.2%). A greater risk of mood disorder was associated with concurrent neuropsychiatric events (P ≤ 0.01), and a lower risk was associated with Asian race/ethnicity (P = 0.01) and treatment with immunosuppressive drugs (P = 0.003). Mood disorders were associated with lower mental health and mental component summary scores but not with the SLEDAI-2K, SDI, or lupus autoantibodies. Among the 232 patients with depression, 168 (72.4%) were treated with antidepressants. One hundred twenty-six (49.2%) of 256 mood disorders resolved in 117 (50.4%) of 232 patients. CONCLUSION: Mood disorders, the second most frequent neuropsychiatric event in patients with SLE, have a negative impact on health-related quality of life and improve over time. The lack of association with global SLE disease activity, cumulative organ damage, and lupus autoantibodies emphasizes the multifactorial etiology of mood disorders and a role for non-lupus-specific therapies.

Published
2015

2. End-stage renal disease in African Americans with lupus nephritis is associated with APOL1

Author

Freedman, Barry I, Langefeld, Carl D, Andringa, Kelly K, Croker, Jennifer A, Williams, Adrienne H, Garner, Neva E, Birmingham, Daniel J, Hebert, Lee A, Hicks, Pamela J, Segal, Mark S, Edberg, Jeffrey C, Brown, Elizabeth E, Alarcón, Graciela S, Costenbader, Karen H, Comeau, Mary E, Criswell, Lindsey A, Harley, John B, James, Judith A, Kamen, Diane L, Lim, S Sam, Merrill, Joan T, Sivils, Kathy L, Niewold, Timothy B, Patel, Neha M, Petri, Michelle, Ramsey-Goldman, Rosalind, Reveille, John D, Salmon, Jane E, Tsao, Betty P, Gibson, Keisha L, Byers, Joyce R, Vinnikova, Anna K, Lea, Janice P, Julian, Bruce A, Kimberly, Robert P, and Lupus Nephritis–End‐Stage Renal Disease Consortium

Subjects
Adult, Male, Kidney Disease, HDL, Genotype, Lipoproteins, Clinical Sciences, Immunology, Lupus, Autoimmune Disease, White People, Kidney Failure, Risk Factors, Clinical Research, Genetics, Humans, 2.1 Biological and endogenous factors, Genetic Predisposition to Disease, Genetic Testing, Chronic, Aetiology, Alleles, Lupus Nephritis–End‐Stage Renal Disease Consortium, Inflammatory and immune system, Middle Aged, Apolipoprotein L1, Lupus Nephritis, Arthritis & Rheumatology, Black or African American, Apolipoproteins, Logistic Models, Disease Progression, Public Health and Health Services, Female
Abstract

ObjectiveLupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus (SLE) that exhibits familial aggregation and may progress to end-stage renal disease (ESRD). LN is more prevalent among African Americans than among European Americans. This study was undertaken to investigate the hypothesis that the apolipoprotein L1 gene (APOL1) nephropathy risk alleles G1/G2, common in African Americans and rare in European Americans, contribute to the ethnic disparity in risk.MethodsAPOL1 G1 and G2 nephropathy alleles were genotyped in 855 African American SLE patients with LN-ESRD (cases) and 534 African American SLE patients without nephropathy (controls) and tested for association under a recessive genetic model, by logistic regression.ResultsNinety percent of the SLE patients were female. The mean ± SD age at SLE diagnosis was significantly lower in LN-ESRD cases than in SLE non-nephropathy controls (27.3 ± 10.9 years versus 39.5 ± 12.2 years). The mean ± SD time from SLE diagnosis to development of LN-ESRD in cases was 7.3 ± 7.2 years. The G1/G2 risk alleles were strongly associated with SLE-ESRD, with 25% of cases and 12% of controls having 2 nephropathy alleles (odds ratio [OR] 2.57, recessive model P = 1.49 × 10(-9)), and after adjustment for age, sex, and ancestry admixture (OR 2.72, P = 6.23 × 10(-6)). The age-, sex-, and admixture-adjusted population attributable risk for ESRD among patients with G1/G2 polymorphisms was 0.26, compared to 0.003 among European American patients. The mean time from SLE diagnosis to ESRD development was ∼2 years earlier among individuals with APOL1 risk genotypes (P = 0.01).ConclusionAPOL1 G1/G2 alleles strongly impact the risk of LN-ESRD in African Americans, as well as the time to progression to ESRD. The high frequency of these alleles in African Americans with near absence in European Americans explains an important proportion of the increased risk of LN-ESRD in African Americans.

Published
2014

3. The incidence and prevalence of systemic lupus erythematosus, 2002-2004: The Georgia Lupus Registry

Author

Lim, S. Sam, Bayakly, A. Rana, Helmick, Charles G., Gordon, Caroline, Easley, Kirk, and Drenkard, Cristina

Subjects
Adult, Male, Georgia, Incidence, Racial Groups, Age Factors, Middle Aged, Article, Sex Factors, Prevalence, Humans, Lupus Erythematosus, Systemic, Female, Registries, Retrospective Studies
Abstract

The Georgia Lupus Registry is a population-based registry designed to improve our ability to estimate the incidence and prevalence of systemic lupus erythematosus (SLE) in a large population.Potential cases of SLE were identified from multiple sources during the years 2002 through 2004. Cases were defined according to the American College of Rheumatology (ACR) criteria for SLE or a combined definition. Age-standardized rates were determined and stratified by race and sex. With capture-recapture analyses, we estimated the under-ascertainment of cases.Using the ACR case definition, the overall crude and age-adjusted incidence rate was 5.6 per 100,000, with capture-recapture and combined definition rates being slightly higher. The age-adjusted incidence rate in women was5 times higher than that for men (9.2 versus 1.8). Black women had an incidence rate nearly 3 times higher than that in white women, with a significantly higher rate in the group ages 30-59 years. The overall crude and age-adjusted prevalence rates were 74.4 and 73 per 100,000, respectively. The age-adjusted prevalence rate in women was nearly 9 times higher than that for men (127.6 versus 14.7). Black women had very high rates (196.2). A striking difference was seen in the proportion of prevalent cases with end-stage renal disease, with 7-fold greater involvement among black patients.With the more complete case-finding methods we used, the incidence and prevalence rates of SLE are among the highest reported in the US. The results continue to underscore striking sex, age, and racial disparities between black patients and white patients with SLE.

Published
2013

4. Cerebrovascular Events in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study

Author

Hanly, John G, Li, Qiuju, Su, Li, Urowitz, Murray B, Gordon, Caroline, Bae, Sang-Cheol, Romero-Diaz, Juanita, Sanchez-Guerrero, Jorge, Bernatsky, Sasha, Clarke, Ann E, Wallace, Daniel J, Isenberg, David A, Rahman, Anisur, Merrill, Joan T, Fortin, Paul, Gladman, Dafna D, Bruce, Ian N, Petri, Michelle, Ginzler, Ellen M, Dooley, MA, Steinsson, Kristjan, Ramsey-Goldman, Rosalind, Zoma, Asad A, Manzi, Susan, Nived, Ola, Jonsen, Andreas, Khamashta, Munther A, Alarcón, Graciela S, Chatham, Winn, Van Vollenhoven, Ronald F, Aranow, Cynthia, Mackay, Meggan, Ruiz-Irastorza, Guillermo, Ramos-Casals, Manuel, Lim, S Sam, Inanc, Murat, Kalunian, Kenneth C, Jacobsen, Soren, Peschken, Christine A, Kamen, Diane L, Askanase, Anca, Theriault, Chris, and Farewell, Vernon

Subjects
Adult, Male, Cerebrovascular Disorders, Young Adult, Quality of Life, Humans, Lupus Erythematosus, Systemic, Female, Prospective Studies, Middle Aged, skin and connective tissue diseases, 3. Good health
Abstract

OBJECTIVE: To determine the frequency, characteristics, and outcomes of cerebrovascular events (CerVEs), as well as clinical and autoantibody associations in a multiethnic/racial inception cohort of patients with systemic lupus erythematosus (SLE). METHODS: A total of 1,826 patients were assessed annually for 19 neuropsychiatric (NP) events, including 5 types of CerVEs: 1) stroke, 2) transient ischemia, 3) chronic multifocal ischemia, 4) subarachnoid/intracranial hemorrhage, and 5) sinus thrombosis. Global disease activity (Systemic Lupus Erythematosus Disease [SLE] Activity Index 2000), damage scores (SLE International Collaborating Clinics/American College of Rheumatology Damage Index), and Short Form 36 (SF-36) scores were collected. Time to event, linear and logistic regressions, and multistate models were used as appropriate. RESULTS: CerVEs were the fourth most frequent NP event: 82 of 1,826 patients had 109 events; of these events, 103 were attributed to SLE, and 44 were identified at the time of enrollment. The predominant events were stroke (60 of 109 patients) and transient ischemia (28 of 109 patients). CerVEs were associated with other NP events attributed to SLE, non-SLE-attributed NP events, African ancestry (at US SLICC sites), and increased organ damage scores. Lupus anticoagulant increased the risk of first stroke and sinus thrombosis and transient ischemic attack. Physician assessment indicated resolution or improvement in the majority of patients, but patients reported sustained reduction in SF-36 summary and subscale scores following a CerVE. CONCLUSION: CerVEs, the fourth most frequent NP event in SLE, are usually attributable to lupus. In contrast to good physician-reported outcomes, patients reported a sustained reduction in health-related quality of life following a CerVE.

5. Economic Evaluation of Damage Accrual in an International SLE Inception Cohort

Author

Barber, Megan, Bruce, Ian N., Urowitz, Murray, Hanly, John G., Su, Li, Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Bernatsky, Sasha, Wallace, Daniel J., Merrill, Joan T., Isenberg, David A., Rahman, Anisur, Ginzler, Ellen M., Petri, Michelle, Dooley, Mary Anne, Fortin, Paul R., Gladman, Dafna D., Sanchez-Guerrero, Jorge, Steinsson, Kristjan, Ramsey-Goldman, Rosalind, Khamashta, M., Aranow, Cynthia, Alarcon, Graciela S., Fessler, Barri J., Manzi, Susan, Nived, Ola, Jonsen, Andreas, Zoma, Asad, Vollenhoven, Ronald F., Manuel Ramos-Casals, Ruiz-Irastorza, Guillermo, Lim, S. Sam, Kalunian, Kenneth C., Inanc, Murat, Kamen, Diane L., Peschken, Christine A., Jacobsen, Soren, Askanase, Anca, Buyon, Jill P., Theriault, Chris, Farewell, Vernon, and Clarke, Ann E.

6. Mood Disorders in Systemic Lupus Erythematousus (SLE): Results from an International, Inception Cohort Study

Author

Hanly, John G., Su, Li, Urowitz, Murray, Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Bernatsky, Sasha R., Clarke, Ann E., Wallace, Daniel J., Merrill, Joan T., Isenberg, David A., Rahman, Anisur, Ginzler, Ellen M., Fortin, Paul, Gladman, Dafna D., Sanchez-Guerrero, Jorge, Petri, Michelle A., Bruce, Ian, Dooley, Mary Anne, Ramsey-Goldman, Rosalind, Aranow, Cynthia, Alarcon, Graciela S., Fessler, Barri J., Steinsson, Kristjan, Nived, Ola, Sturfelt, Gunnar K., Manzi, Susan, Khamashta, Munther A., Vollenhoven, Ronald F., Zoma, Asad, Ramos-Casals, Manuel, Guillermo Ruiz-Irastorza, Lim, S. Sam, Stoll, Thomas, Inanc, Murat, Kalunian, Kenneth C., Kamen, Diane L., Maddison, Peter, Peschken, Christine A., Jacobsen, Soren, Askanase, Anca, Buyon, Jill P., Theriault, Chris, Thompson, Kara, and Farewell, Vernon

Subjects
Clinical Sciences, Immunology, Public Health and Health Services, Arthritis & Rheumatology

7. Incidence and Predictors of Atherosclerotic Vascular Events in a Multicentre Inception SLE Cohort

Author

Urowitz, Murray, Gladman, Dafna, Su, Jiandong, Farewell, Vernon, Sanchez-Guerrero, Jorge, Romero-Diaz, Juanita, Bae, Sang-Cheol, Fortin, Paul, Nived, Ola, Clarke, Ann E., Bernatsky, Sasha, Gordon, Caroline, Hanly, John, Wallace, Daniel J., Isenberg, David A., Rahman, Anisur, Merrill, Joan, Ginzler, Ellen M., Alarcon, Graciela, Petri, Michelle, Bruce, Ian, Khamashta, Munther A., Aranow, Cynthia, Manzi, Susan, Dooley, M. A., Ramsey-Goldman, Rosalind, Jonsen, Andreas, Steinsson, Kristjan, Zoma, Asad, Guillermo Ruiz-Irastorza, Lim, S. Sam, Kalunian, Kenneth C., Inanc, Murat, Vollenhoven, Ronald, Ramos, Manuel, Kamen, Diane, Jacobsen, Soren, Peschken, Christine, Askanase, Anca, and Stoll, Thomas

8. Prediction of Organ Damage Accrual in Systemic Lupus Erythematosus Using a Frailty Index

Author

Legge, Alexandra, Kirkland, Susan, Rockwood, Kenneth, Andreou, Pantelis, Bae, Sang-Cheol, Gordon, Caroline, Romero-Diaz, Juanita, Sanchez-Guerrero, Jorge, Wallace, Daniel J., Bernatsky, Sasha, Clarke, Ann E., Merrill, Joan, Ginzler, Ellen M., Fortin, Paul, Gladman, Dafna, Urowitz, Murray, Bruce, Ian, Isenberg, David A., Rahman, Anisur, Alarcon, Graciela, Petri, Michelle, Khamashta, Munther A., Dooley, M. A., Ramsey-Goldman, Rosalind, Manzi, Susan, Steinsson, Kristjan, Zoma, Asad A., Aranow, Cynthia, Mackay, Meggan, Guillermo Ruiz-Irastorza, Lim, S. Sam, Inanc, Murat, Vollenhoven, Ronald F., Jonsen, Andreas, Nived, Ola, Ramos-Casals, Manuel, Kamen, Diane, Kalunian, Kenneth C., Jacobsen, Soren, Peschken, Christine, Askanase, Anca, and Hanly, John G.

9. The Initial Presentation of Cerebrovascular Disease Attributed to Lupus Is Most Frequent Early in the Disease Course: Results from an International, Inception Cohort Study

Author

Hanly, John G., Li, Qiuju, Su, Li, Urowitz, Murray, Romero-Diaz, Juanita, Gordon, C., Bae, Sang-Cheol, Bernatsky, Sasha R., Clarke, Ann, Wallace, Daniel J., Merrill, Joan T., Isenberg, David A., Rahman, Anisur, Ginzler, Ellen M., Petri, Michelle, Bruce, Ian N., Dooley, Mary Anne, Fortin, Paul, Gladman, Dafna D., Sanchez-Guerrero, Jorge, Steinsson, Kristjan, Ramsey-Goldman, Rosalind, Khamashta, Munther, Aranow, Cynthia, Alarcon, Graciela S., Fessler, Barri J., Manzi, Susan, Nived, Ola, Sturfelt, Gunnar K., Zoma, Asad, Vollenhoven, Ronald F., Ramos-Casals, Manuel, Guillermo Ruiz-Irastorza, Lim, S. Sam, Kalunian, Kenneth C., Inanc, Murat, Kamen, Diane L., Peschken, Christine A., Jacobsen, Soren, Askanase, Anca, Theriault, Chris, and Farewell, Vernon

10. Mood Disorders in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study

Author

Hanly, John G, Su, Li, Urowitz, Murray B, Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Bernatsky, Sasha, Clarke, Ann E, Wallace, Daniel J, Merrill, Joan T, Isenberg, David A, Rahman, Anisur, Ginzler, Ellen M, Petri, Michelle, Bruce, Ian N, Dooley, MA, Fortin, Paul, Gladman, Dafna D, Sanchez-Guerrero, Jorge, Steinsson, Kristjan, Ramsey-Goldman, Rosalind, Khamashta, Munther A, Aranow, Cynthia, Alarcón, Graciela S, Fessler, Barri J, Manzi, Susan, Nived, Ola, Sturfelt, Gunnar K, Zoma, Asad A, Van Vollenhoven, Ronald F, Ramos-Casals, Manuel, Ruiz-Irastorza, Guillermo, Lim, S Sam, Kalunian, Kenneth C, Inanc, Murat, Kamen, Diane L, Peschken, Christine A, Jacobsen, Soren, Askanase, Anca, Theriault, Chris, Thompson, Kara, and Farewell, Vernon

Subjects
Adult, Male, Internationality, Mood Disorders, Incidence, Black People, Hispanic or Latino, Middle Aged, White People, 3. Good health, Cohort Studies, Asian People, Disease Progression, Quality of Life, Humans, Lupus Erythematosus, Systemic, Regression Analysis, Female, Prospective Studies, Autoantibodies
Abstract

OBJECTIVE: To examine the frequency, characteristics, and outcome of mood disorders, as well as clinical and autoantibody associations, in a multiethnic/racial, prospective inception cohort of patients with systemic lupus erythematosus (SLE). METHODS: Patients were assessed annually for mood disorders (4 types, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and 18 other neuropsychiatric events. Global disease activity scores (SLE Disease Activity Index 2000 [SLEDAI-2K]), damage scores (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI]), and Short Form 36 subscales, mental and physical component summary scores were collected. Time to event, linear and ordinal regressions, and multi-state models were used as appropriate. RESULTS: Among the 1,827 patients with SLE, 88.9% were female, and 48.9% were Caucasian. The mean ± SD age of the patients was 35.1 ± 13.3 years, disease duration was 5.6 ± 4.8 months, and the length of followup was 4.7 ± 3.5 years. During the course of the study, 863 (47.2%) of the 1,827 patients had 1,627 neuropsychiatric events. Mood disorders occurred in 232 (12.7%) of 1,827 patients, and 98 (38.3%) of 256 mood disorder events were attributed to SLE. The estimated cumulative incidence of any mood disorder after 10 years was 17.7% (95% confidence interval 15.1, 20.2%). A greater risk of mood disorder was associated with concurrent neuropsychiatric events (P ≤ 0.01), and a lower risk was associated with Asian race/ethnicity (P = 0.01) and treatment with immunosuppressive drugs (P = 0.003). Mood disorders were associated with lower mental health and mental component summary scores but not with the SLEDAI-2K, SDI, or lupus autoantibodies. Among the 232 patients with depression, 168 (72.4%) were treated with antidepressants. One hundred twenty-six (49.2%) of 256 mood disorders resolved in 117 (50.4%) of 232 patients. CONCLUSION: Mood disorders, the second most frequent neuropsychiatric event in patients with SLE, have a negative impact on health-related quality of life and improve over time. The lack of association with global SLE disease activity, cumulative organ damage, and lupus autoantibodies emphasizes the multifactorial etiology of mood disorders and a role for non-lupus-specific therapies.

11. Risk Factors for Cerebrovascular Events in Systemic Lupus Erythematosus: Results from an International, Inception Cohort Study

Author

Hanly, John G., Li, Qiuju, Su, Li, Urowitz, Murray, Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Bernatsky, Sasha, Clarke, Ann E., Wallace, Daniel J., Merrill, Joan T., Isenberg, David A., Rahman, Anisur, Ginzler, Ellen M., Fortin, Paul R., Gladman, D., Sanchez-Guerrero, Jorge, Petri, Michelle, Bruce, Ian N., Dooley, Mary Anne, Ramsey-Goldman, Rosalind, Aranow, Cynthia, Alarcon, Graciela S., Steinsson, Kristjan, Sturfelt, Gunnar K., Nived, Ola, Manzi, Susan, Khamashta, M., Vollenhoven, Ronald F., Zoma, Asad, Guillermo Ruiz-Irastorza, Lim, S. Sam, Inanc, Murat, Kalunian, Kenneth C., Kamen, Diane L., Peschken, Christine A., Jacobsen, Soren, Askanase, Anca, Theriault, Chris, Farewell, Vernon, and Ramos-Casals, Manuel

12. 'Lupus Headache': Results From a Prospective, International, Inception Cohort Study

Author

Hanly, John G., Urowitz, Murray B., O Keeffe, Aidan, Gordon, Caroline, Bae, Sang-Cheol, Sanchez-Guerrero, Jorge, Romero-Diaz, Juanita, Clarke, Ann E., Bernatsky, Sasha, Wallace, Daniel J., Ginzler, E. M., Isenberg, David A., Rahman, Anisur, Merrill, Joan T., Petri, Michelle A., Fortin, Paul R., Gladman, D. D., Fessler, Barri J., Alarcon, Graciela S., Bruce, Ian N., Dooley, Mary Anne, Steinsson, Kristjan, Khamashta, Munther A., Ramsey-Goldman, Rosalind, Manzi, Susan, Sturfelt, Gunnar K., Nived, Ola, Zoma, Asad A., Vollenhoven, R. F., Ramos-Casals, Manuel, Aranow, Cynthia, Mackay, Meggan, Guillermo Ruiz-Irastorza, Kalunian, Kenneth C., Lim, S. Sam, Inanc, Murat, Kamen, Diane L., Peschken, Christine, Jacobsen, Soren, Theriault, Chris, Thompson, Kara, and Farewell, Vernon

13. The Prevalence of Anti-DFS70 Antibodies in an International Inception Cohort of Systemic Lupus Erythematosus

Author

Choi, May, Hanly, John G., Urowitz, Murray, Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Bernatsky, Sasha, Wallace, Daniel J., Merrill, Joan T., Isenberg, David A., Rahman, Anisur, Ginzler, Ellen M., Fortin, Paul R., Gladman, Dafna, Sanchez-Guerrero, Jorge, Petri, Michelle, Bruce, Ian N., Dooley, Mary Anne, Ramsey-Goldman, Rosalind, Aranow, Cynthia, Alarcon, Graciela S., Steinsson, Kristjan, Nived, Ola, Sturfelt, Gunnar K., Manzi, Susan, Khamashta, Munther, Vollenhoven, Ronald F., Zoma, Asad, Ruiz-Irastorza, Guillermo, Lim, S. Sam, Stoll, Thomas, Inanc, Murat, Kalunian, Kenneth C., Kamen, Diane L., Maddison, Peter, Peschken, Christine A., Jacobsen, Soren, Askanase, Anca, Buyon, Jill P., Chatham, W. Winn, Manuel Ramos-Casals, Pierre, Yvan St, Clarke, Ann E., and Fritzler, Marvin J.

14. Hydroxychloroquine prescription trends and predictors for excess dosing per recent ophthalmology guidelines

Author

Jorge, April M., Melles, Ronald B., Zhang, Yuqing, Lu, Na, Rai, Sharan K., Young, Lucy H., Costenbader, Karen H., Ramsey-Goldman, Rosalind, Lim, S. Sam, Esdaile, John M., Clarke, Ann E., Urowitz, M. B., Askanase, Anca Dinu, Aranow, Cynthia, Petri, Michelle, and Choi, Hyon

Subjects
Rheumatology, Epidemiology, Rheumatoid arthritis--Treatment, Drugs, Systemic lupus erythematosus--Alternative treatment, 3. Good health
Abstract

Background Hydroxychloroquine (HCQ) retinopathy may be more common than previously recognized; recent ophthalmology guidelines have revised recommendations from ideal body weight (IBW)-based dosing to actual body weight (ABW)-based dosing. However, contemporary HCQ prescribing trends in the UK remain unknown. Methods We examined a UK general population database to investigate HCQ dosing between 2007 and 2016. We studied trends of excess HCQ dosing per ophthalmology guidelines (defined by exceeding 6.5 mg/kg of IBW and 5.0 mg/kg of ABW) and determined their independent predictors using multivariable logistic regression analyses. Results Among 20,933 new HCQ users (78% female), the proportions of initial HCQ excess dosing declined from 40% to 36% using IBW and 38% to 30% using ABW, between 2007 and 2016. Among these, 47% of women were excess-dosed (multivariable OR 12.52; 95% CI 10.99–14.26) using IBW and 38% (multivariable OR 1.98; 95% CI,1.81–2.15) using ABW. Applying IBW, 37% of normal and 44% of obese patients were excess-dosed; however, applying ABW, 53% of normal and 10% of obese patients were excess-dosed (multivariable ORs = 1.61 and 0.1 (reference = normal); both p

15. Outcome of Lupus Nephritis and Impact on Health Related Quality of Life: Results from an International, Prospective, Inception Cohort Study

Author

Hanly, John G., O Keeffe, Aidan, Su, Li, Urowitz, Murray B., Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Bernatsky, Sasha R., Clarke, Ann E., Wallace, Daniel J., Merrill, Joan T., Isenberg, David A., Rahman, Anisur, Ginzler, Ellen M., Fortin, Paul, Gladman, Dafna D., Sanchez-Guerrero, Jorge, Petri, Michelle A., Bruce, Ian, Dooley, Mary Anne, Ramsey-Goldman, Rosalind, Aranow, Cynthia, Alarcon, Graciela S., Fessler, Barri, Steinsson, Kristjan, Nived, Ola, Sturfelt, Gunnar, Manzi, Susan, Khamashta, Munther A., Vollenhoven, Ronald F., Zoma, Asad, Ramos-Casals, Manuel, Guillermo Ruiz-Irastorza, Lim, S. Sam, Stoll, Thomas, Inanc, Murat, Kalunian, Kenneth C., Kamen, Diane L., Maddison, Peter, Peschken, Christine A., Jacobsen, Soren, Askanase, Anca, Buyon, Jill P., Theriault, Chris, Thompson, Kara, and Farewell, Vernon

16. Construction and Validation of a Frailty Index As a Novel Health Measure in Systemic Lupus Erythematosus

Author

Legge, Alexandra, Kirkland, Susan, Rockwood, Kenneth, Andreou, Pantelis, Bae, Sang-Cheol, Gordon, Caroline, Romero-Diaz, Juanita, Sanchez-Guerrero, Jorge, Wallace, Daniel, Bernatsky, Sasha, Clarkel, Ann E., Merrill, Joan T., Ginzlert, Ellen M., Fortin, Paul R., Gladman, Dafna D., Urowitz, Murray, Bruce, Ian N., Isenbere, David A., Rahman, Anisur, Alarcon, Graciela S., Petri, Michelle, Khamashta, Munther A., Dooley, Mary, Ramsey-Goldman, Rosalind, Manzi, Susan, Steinsson, Kristjan, Zoma, Asad A., Aranow, Cynthia, Mackay, Meggan, Ruiz-Irastorza, Guillermo, Lim, S. Sam, Inanc, Murat, Vollenhoven, Ronald F., Jonsen, Andreas, Nived, Ola, Manuel Ramos-Casals, Kamen, Diane L., Kalunian, Kenneth C., Jacobsen, Soren, Peschken, Christine A., Askanase, Anca, and Hanly, John G.

17. Economic Evaluation of Lupus Nephritis in an International Inception Cohort: Comparing the Hospitalization, Medication, Dialysis, and Procedure Costs of Those with and without Nephritis

Author

Barber, Megan, Hanly, John G., O Keeffe, Aidan, Su, Li, Urowitz, Murray, St Pierre, Yvan, Romero-Diaz, Juanita, Gordon, C., Bae, Sang-Cheol, Bernatsky, Sasha, Wallace, Daniel J., Merrill, Joan T., Isenberg, David A., Rahman, Anisur, Ginzler, Ellen M., Fortin, Paul R., Gladman, Dafna D., Sanchez-Guerrero, Jorge, Petri, Michelle, Bruce, Ian N., Dooley, Mary Anne, Ramsey-Goldman, Rosalind, Aranow, Cynthia, Alarcon, Graciela S., Chatham, W. Winn, Steinsson, Kristjan, Nived, Ola, Sturfelt, Gunnar K., Manzi, Susan, Khamashta, Munther, Vollenhoven, Ronald F., Zoma, Asad, Ramos-Casals, Manel, Guillermo Ruiz-Irastorza, Lim, S. Sam, Stoll, Thomas, Inanc, Murat, Kalunian, Kenneth C., Kamen, Diane L., Maddison, Peter, Peschken, Christine A., Jacobsen, Soren, Askanase, Anca, Buyon, Jill P., Theriault, Chris, Thompson, Kara, Farewell, Vernon, and Clarke, Ann E.

18. Cancer in an SLE Inception Cohort: Smoking May out-Perform Tumor Markers As a Risk Predictor

Author

Bernatsky, Sasha, Urowitz, Murray, Hanly, John G., Clarke, Ann E., Fritzler, Marvin J., Gordon, Caroline, Romero-Diaz, Juanita, Alarcon, Graciela S., Bae, Sang-Cheol, Petri, Michelle, Merrill, Joan T., Wallace, Daniel J., Fortin, Paul R., Gladman, Dafna D., Isenberg, David A., Rahman, Anisur, Manzi, Susan, Nived, Ola, Sturfelt, Gunnar K., Peschken, Christine A., Sanchez-Guerrero, Jorge, Guillermo Ruiz-Irastorza, Aranow, Cynthia, Vollenhoven, Ronald F., Zoma, Asad, Steinsson, Kristjan, Khamashta, Munther A., Ginzler, Ellen M., Askanase, Anca, Kalunian, Kenneth C., Dooley, Mary Anne, Lim, S. Sam, Kamen, Diane L., Jacobsen, Soren, Ramos-Casals, Manuel, Inanc, Murat, Lee, Jennifer L. F., and Ramsey-Goldman, Rosalind

19. Outcomes After Hydroxychloroquine Reduction or Discontinuation in a Multinational Inception Cohort of Systemic Lupus

Author

Almeida-Brasil, Celline, Hanly, John, Urowitz, Murray, Clarke, Ann, Ramsey-Goldman, Rosalind, Gordon, Caroline, Petri, Michelle, Ginzler, Ellen M., Wallace, Daniel J., Bae, Sang-Cheol, Romero-Diaz, Juanita, Dooley, Mary Ann, Peschken, Christine A., Isenberg, David, Rahman, Anisur, Manzi, Susan, Jacobsen, Soren, Lim, S. Sam, Vollenhoven, Ronald, Nived, Ola, Jonsen, Andreas, Kamen, Diane, Aranow, Cynthia, Guillermo Ruiz-Irastorza, Sanchez-Guerrero, Jorge, Gladman, Dafna, Fortin, Paul, Alarcon, Graciela, Merrill, Joan, Kalunian, Kenneth, Ramos-Casals, Manuel, Steinsson, Kristjan, Zoma, Asad, Askanase, Anca, Khamashta, Munther, Bruce, Ian, Inanc, Murat, and Bernatsky, Sasha

20. Is ANA-status at Disease Inception Associated with Long-term Damage Accrual and Direct and Indirect Health Care Costs in the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort?

Author

Choi, May, Barber, Megan, Fritzler, Marvin, Hanly, John G., Urowitz, Murray, St-Pierre, Yvan, Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Bernatsky, Sasha, Wallace, Daniel J., Isenberg, David A., Rahman, Anisur, Ginzler, Ellen M., Petri, Michelle, Bruce, Ian, Fortin, Paul, Gladman, Dafna, Sanchez-Guerrero, Jorge, Ramsey-Goldman, Rosalind, Khamashta, Munther A., Aranow, Cynthia, Mackay, Meggan, Alarcon, Graciela, Manzi, Susan, Nived, Ola, Jonsen, Andreas, Zoma, Asad, Vollenhoven, Ronald, Ramos-Casals, Manuel, Guillermo Ruiz-Irastorza, Lim, S. Sam, Kalunian, Kenneth C., Inanc, Murat, Kamen, Diane, Peschken, Christine, Jacobsen, Soren, Askanase, Anca, Farewell, Vernon, and Clarke, Ann E.

21. Retinal Toxicity in a Multinational Inception Cohort of Systemic Lupus Patients on Hydroxychloroquine

Author

Almeida-Brasil, Celline, Hanly, John, Urowitz, Murray, Clarke, Ann, Ramsey-Goldman, Rosalind, Gordon, Caroline, Petri, Michelle, Ginzler, Ellen M., Wallace, Daniel J., Bae, Sang-Cheol, Romero-Diaz, Juanita, Dooley, Mary Ann, Peschken, Christine A., Isenberg, David, Rahman, Anisur, Manzi, Susan, Jacobsen, Soren, Lim, S. Sam, Vollenhoven, Ronald, Nived, Ola, Jonsen, Andreas, Kamen, Diane, Aranow, Cynthia, Guillermo Ruiz-Irastorza, Sanchez-Guerrero, Jorge, Gladman, Dafna, Fortin, Paul, Alarcon, Graciela, Merrill, Joan, Kalunian, Kenneth, Ramos-Casals, Manuel, Steinsson, Kristjan, Zoma, Asad, Askanase, Anca, Khamashta, Munther, Bruce, Ian, Inanc, Murat, and Bernatsky, Sasha

22. Economic Evaluation of Lupus Nephritis in the Systemic Lupus International Collaborating Clinics Inception Cohort Using a Multistate Model Approach

Author

Barber, Megan RW, Hanly, John G, Su, Li, Urowitz, Murray B, St Pierre, Yvan, Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Bernatsky, Sasha, Wallace, Daniel J, Isenberg, David A, Rahman, Anisur, Ginzler, Ellen M, Petri, Michelle, Bruce, Ian N, Fortin, Paul R, Gladman, Dafna D, Sanchez-Guerrero, Jorge, Ramsey-Goldman, Rosalind, Khamashta, Munther A, Aranow, Cynthia, Mackay, Meggan, Alarcón, Graciela S, Manzi, Susan, Nived, Ola, Jönsen, Andreas, Zoma, Asad A, Van Vollenhoven, Ronald F, Ramos-Casals, Manuel, Ruiz-Irastorza, Guillermo, Lim, S Sam, Kalunian, Kenneth C, Inanc, Murat, Kamen, Diane L, Peschken, Christine A, Jacobsen, Soren, Askanase, Anca, Theriault, Chris, Farewell, Vernon, and Clarke, Ann E

Subjects
Adult, Cohort Studies, Male, Young Adult, Models, Economic, Humans, Female, Health Care Costs, Middle Aged, urologic and male genital diseases, Lupus Nephritis, 3. Good health
Abstract

OBJECTIVE: Little is known about the long-term costs of lupus nephritis (LN). The costs were compared between patients with and without LN using multistate modeling. METHODS: Patients from 32 centers in 11 countries were enrolled in the Systemic Lupus International Collaborating Clinics inception cohort within 15 months of diagnosis and provided annual data on renal function, hospitalizations, medications, dialysis, and selected procedures. LN was diagnosed by renal biopsy or the American College of Rheumatology classification criteria. Renal function was assessed annually using the estimated glomerular filtration rate (GFR) or estimated proteinuria. A multistate model was used to predict 10-year cumulative costs by multiplying annual costs associated with each renal state by the expected state duration. RESULTS: A total of 1,545 patients participated; 89.3% were women, the mean ± age at diagnosis was 35.2 ± 13.4 years, 49% were white, and the mean followup duration was 6.3 ± 3.3 years. LN developed in 39.4% of these patients by the end of followup. Ten-year cumulative costs were greater in those with LN and an estimated glomerular filtration rate (GFR) 60 ml/minute) or with LN and estimated proteinuria >3 gm/day ($84,040 versus $20,499 if no LN and estimated proteinuria

23. Peripheral Nervous System Disease in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study

Author

Hanly, John G, Li, Qiuju, Su, Li, Urowitz, Murray B, Gordon, Caroline, Bae, Sang-Cheol, Romero-Diaz, Juanita, Sanchez-Guerrero, Jorge, Bernatsky, Sasha, Clarke, Ann E, 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, MA, Steinsson, Kristjan, Ramsey-Goldman, Rosalind, Zoma, Asad A, Manzi, Susan, Nived, Ola, Jonsen, Andreas, Khamashta, Munther A, Alarcón, Graciela S, Svenungsson, Elisabet, Van Vollenhoven, Ronald F, Aranow, Cynthia, Mackay, Meggan, Ruiz-Irastorza, Guillermo, Ramos-Casals, Manuel, Lim, S Sam, Inanc, Murat, Kalunian, Kenneth C, Jacobsen, Soren, Peschken, Christine A, Kamen, Diane L, Askanase, Anca, Theriault, Chris, and Farewell, Vernon

Subjects
Adult, Male, Lupus Vasculitis, Central Nervous System, Mononeuropathies, Age Factors, Peripheral Nervous System Diseases, Middle Aged, Severity of Illness Index, Cranial Nerve Diseases, 3. Good health, Cohort Studies, Young Adult, Multivariate Analysis, Humans, Lupus Erythematosus, Systemic, Female, Proportional Hazards Models
Abstract

OBJECTIVE: To determine the frequency, clinical characteristics, associations, and outcomes of different types of peripheral nervous system (PNS) disease in a multiethnic/multiracial, prospective inception cohort of systemic lupus erythematosus (SLE) patients. METHODS: Patients were evaluated annually for 19 neuropsychiatric (NP) events including 7 types of PNS disease. SLE disease activity, organ damage, autoantibodies, and patient and physician assessment of outcome were measured. Time to event and linear regressions were used as appropriate. RESULTS: Of 1,827 SLE patients, 88.8% were female, and 48.8% were white. The mean ± SD age was 35.1 ± 13.3 years, disease duration at enrollment was 5.6 ± 4.2 months, and follow-up was 7.6 ± 4.6 years. There were 161 PNS events in 139 (7.6%) of 1,827 patients. The predominant events were peripheral neuropathy (66 of 161 [41.0%]), mononeuropathy (44 of 161 [27.3%]), and cranial neuropathy (39 of 161 [24.2%]), and the majority were attributed to SLE. Multivariate Cox regressions suggested longer time to resolution in patients with a history of neuropathy, older age at SLE diagnosis, higher SLE Disease Activity Index 2000 scores, and for peripheral neuropathy versus other neuropathies. Neuropathy was associated with significantly lower Short Form 36 (SF-36) physical and mental component summary scores versus no NP events. According to physician assessment, the majority of neuropathies resolved or improved over time, which was associated with improvements in SF-36 summary scores for peripheral neuropathy and mononeuropathy. CONCLUSION: PNS disease is an important component of total NPSLE and has a significant negative impact on health-related quality of life. The outcome is favorable for most patients, but our findings indicate that several factors are associated with longer time to resolution.

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