1. First month prednisone dose predicts prednisone burden during the following 11 months: an observational study from the RELES cohort
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Ruiz-Irastorza, G., Garcia, M., Espinosa, G., Caminal, L., Mitjavila, F., Gonzalez-Leon, R., Sopena, B., Canora, J., Villalba, M. V., Rodriguez-Carballeira, M., Lopez-Dupla, J. M., Callejas, J. L., Castro, A., Tolosa, C., Sanchez-Garcia, M. E., Perez-Conesa, M., Navarrete-Navarrete, N., Rodriguez, A. P., Herranz, M. T., Pallares, L., RELES, Autoimmune Dis Study Grp GEAS, [Ruiz-Irastorza, G.] Univ Basque Country, Autoimmune Dis Res Unit, Dept Internal Med, BioCruces Hlth Res Inst,Hosp Univ Cruces, Baracaldo, Bizkaia, Spain, [Garcia, M.] Univ Basque Country, Autoimmune Dis Res Unit, Dept Internal Med, BioCruces Hlth Res Inst,Hosp Univ Cruces, Baracaldo, Bizkaia, Spain, [Espinosa, G.] Hosp Clin Barcelona, Dept Autoimmune Dis, Barcelona, Spain, [Caminal, L.] Hosp Univ Cent Asturias, Dept Internal Med, Oviedo, Asturias, Spain, [Mitjavila, F.] Hosp Univ Bellvitge, Dept Internal Med, Autoimmune Dis Unit, Barcelona, Spain, [Gonzalez-Leon, R.] Hosp Univ Virgen del Rocio, Dept Internal Med, Seville, Spain, [Sopena, B.] Complejo Hosp Univ Vigo, Dept Internal Med, Vigo, Spain, [Canora, J.] Hosp Univ Fuenlabrada, Dept Internal Med, Madrid, Spain, [Villalba, M. V.] Hosp Gen Univ Gregorio Maranon, Dept Internal Med, Madrid, Spain, [Rodriguez-Carballeira, M.] Hosp Univ Mutua Terrasa, Dept Internal Med, Barcelona, Spain, [Lopez-Dupla, J. M.] Hosp Univ Joan XXIII, Dept Internal Med, Tarragona, Spain, [Callejas, J. L.] Hosp Univ San Cecilio, Dept Internal Med, Granada, Spain, [Castro, A.] Hosp Univ St Joan de Reus, Dept Internal Med, Tarragona, Spain, [Tolosa, C.] Corporacio Sanitaria Parc Tauli, Dept Internal Med, Barcelona, Spain, [Sanchez-Garcia, M. E.] Hosp Univ Reina Sofia, Dept Internal Med, Autoimmune Dis Unit, Cordoba, Spain, [Perez-Conesa, M.] Hosp Univ Miguel Servet, Dept Internal Med, Zaragoza, Spain, [Navarrete-Navarrete, N.] Hosp Univ Virgen de las Nieves, Dept Internal Med, Granada, Spain, [Rodriguez, A. P.] Complejo Hosp Univ Ourense, Dept Internal Med, Orense, Spain, [Herranz, M. T.] Hosp JM Morales Meseguer, Dept Internal Med, Murcia, Spain, [Pallares, L.] Hosp Univ Son Espases, Dept Internal Med, Islas Baleares, Spain, Spanish Society of Internal Medicine, RELES, Autoimmune Diseases Study Group (GEAS), [Ruiz-Irastorza,G, Garcia,M] Autoimmune Diseases Research Unit, Department of Internal Medicine, BioCruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Bizkaia, Spain. [Espinosa,G] Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain. [Caminal,L] Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Asturias , Spain. [Mitjavila,F] Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. [González-León,R] Department of Internal Medicine , Hospital Universitario Virgen del Rocío, Sevilla, Spain. [Sopeña,B] Department of Internal Medicine, Complejo Hospitalario Universitario de Vigo, Pontevedra, Vigo , Spain. [Canora,J] Department of Internal Medicine, Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid , Spain. [Villalba,MV] Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain. [Rodríguez-Carballeira,M] Department of Internal Medicine, Hospital Universitario Mutua de Terrasa, Barcelona, Spain. [López-Dupla,JM] Department of Internal Medicine, Hospital Universitario Joan XXIII, Tarragona, Spain. [Callejas,JL] Department of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain. [Castro,A] Department of Internal Medicine, Hospital Universitario Sant Joan de Reus, Reus, Tarragona , Spain. [Tolosa,C] Department of Internal Medicine, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain. [Sánchez-García,ME] Department of Internal Medicine, Autoimmune Diseases Unit, Hospital Universitario Reina Sofía , Córdoba, Spain. [Pérez-Conesa,M] Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain. [Navarrete-Navarrete,N] Department of Internal Medicine , Hospital Universitario Virgen de las Nieves, Granada, Spain. [Rodríguez,AP] Department of Internal Medicine, Complejo Hospitalario Universitario de Ourense, Ourense, Spain. [Herranz,MT] Department of Internal Medicine, Hospital J.M. Morales Meseguer, Murcia, Spain. [Pallarés,L] Department of Internal Medicine, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, Spain., and This study was supported by the Spanish Society of Internal Medicine.
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0301 basic medicine ,Lupus nephritis ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,0302 clinical medicine ,immune system diseases ,Prednisone ,Nefritis lúpica ,Phenomena and Processes::Circulatory and Respiratory Physiological Phenomena::Cardiovascular Physiological Phenomena::Hemodynamics::Pulse [Medical Subject Headings] ,skin and connective tissue diseases ,Diseases::Skin and Connective Tissue Diseases::Connective Tissue Diseases::Lupus Erythematosus, Cutaneous::Lupus Erythematosus, Discoid [Medical Subject Headings] ,Systemic lupus erythematosus ,Lupus eritematoso discoide ,Cumulative dose ,General Medicine ,Humanos ,Chemicals and Drugs::Polycyclic Compounds::Steroids::Pregnanes::Pregnadienes::Pregnadienetriols::Prednisolone::Methylprednisolone [Medical Subject Headings] ,Cohort ,Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Immunologic Factors::Immunosuppressive Agents [Medical Subject Headings] ,Glucocorticoid ,medicine.drug ,medicine.medical_specialty ,Antimaláricos ,Immunology ,Diseases::Skin and Connective Tissue Diseases::Connective Tissue Diseases::Lupus Erythematosus, Systemic::Lupus Nephritis [Medical Subject Headings] ,Brief Communication ,Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Antiparasitic Agents::Antiprotozoal Agents::Antimalarials [Medical Subject Headings] ,Systemic Lupus Erythematosus ,Disease activity ,03 medical and health sciences ,Internal medicine ,Lupus eritematoso sistémico ,medicine ,Corticosteroids ,Metilprednisolona ,Glucocorticoides ,Disease Activity ,030203 arthritis & rheumatology ,business.industry ,Diseases::Skin and Connective Tissue Diseases::Connective Tissue Diseases::Lupus Erythematosus, Systemic [Medical Subject Headings] ,Inmunosupresores ,Pulso arterial ,medicine.disease ,Chemicals and Drugs::Polycyclic Compounds::Steroids::Pregnanes::Pregnadienes::Pregnadienediols::Prednisone [Medical Subject Headings] ,Chemicals and Drugs::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormones::Glucocorticoids [Medical Subject Headings] ,030104 developmental biology ,Endocrinology ,Prednisona ,Observational study ,business - Abstract
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 Espanol de Lupus Eritematoso Sisternico 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 (p7.5 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., This study was supported by the Spanish Society of Internal Medicine.
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- 2016