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151. Accrual of Atherosclerotic Vascular Events in a Multicenter Inception Systemic Lupus Erythematosus Cohort

Author

Urowitz, Murray B., primary, Gladman, Dafna D., additional, Farewell, Vernon, additional, Su, Jiandong, additional, Romero-Diaz, Juanita, additional, Bae, Sang-Cheol, additional, Fortin, Paul R., additional, Sanchez‐Guerrero, Jorge, additional, Clarke, Ann Elaine, additional, Bernatsky, Sasha, additional, Gordon, Caroline, additional, Hanly, John G., additional, Wallace, Daniel J., additional, Isenberg, David A., additional, Rahman, Anisur, additional, Merrill, Joan T., additional, Ginzler, Ellen, additional, Alarcón, Graciela S., additional, Chatham, W. Winn, additional, Petri, Michelle A., additional, Bruce, Ian N., additional, Khamashta, Munther A., additional, Aranow, Cynthia, additional, Dooley, Mary Anne, additional, Manzi, Susan, additional, Ramsey‐Goldman, Rosalind, additional, Nived, Ola, additional, Jönsen, Andreas, additional, Steinsson, Kristján, additional, Zoma, Asad A., additional, Ruiz-Irastorza, Guillermo, additional, Lim, S. Sam, additional, Kalunian, Kenneth C., additional, Ỉnanç, Murat, additional, van Vollenhoven, Ronald, additional, Ramos‐Casals, Manuel, additional, Kamen, Diane L., additional, Jacobsen, Soren, additional, Peschken, Christine A., additional, Askanase, Anca, additional, and Stoll, Thomas, additional

Published
2020
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152. Performance of the 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in early disease, across sexes and ethnicities

Author

Johnson, Sindhu R, primary, Brinks, Ralph, additional, Costenbader, Karen H, additional, Daikh, David, additional, Mosca, Marta, additional, Ramsey-Goldman, Rosalind, additional, Smolen, Josef S, additional, Wofsy, David, additional, Boumpas, Dimitrios T, additional, Kamen, Diane L, additional, Jayne, David, additional, Cervera, R, additional, Costedoat-Chalumeau, Nathalie, additional, Diamond, Betty, additional, Gladman, Dafna D, additional, Hahn, Bevra, additional, Hiepe, Falk, additional, Jacobsen, Søren, additional, Khanna, Dinesh, additional, Lerstrøm, Kirsten, additional, Massarotti, Elena, additional, McCune, Joseph, additional, Ruiz-Irastorza, Guillermo, additional, Sanchez-Guerrero, Jorge, additional, Schneider, Matthias, additional, Urowitz, Murray, additional, Bertsias, George, additional, Hoyer, Bimba F, additional, Leuchten, Nicolai, additional, Tani, Chiara, additional, Tedeschi, Sara K, additional, Touma, Zahi, additional, Schmajuk, Gabriela, additional, Anic, Branimir, additional, Assan, Florence, additional, Chan, Tak Mao, additional, Clarke, Ann Elaine, additional, Crow, Mary K, additional, Czirják, László, additional, Doria, Andrea, additional, Graninger, Winfried B, additional, Halda-Kiss, Bernadett, additional, Hasni, Sarfaraz, additional, Izmirly, Peter M, additional, Jung, Michelle, additional, Kumánovics, Gábor, additional, Mariette, Xavier, additional, Padjen, Ivan, additional, Pego-Reigosa, José M, additional, Romero-Diaz, Juanita, additional, Rúa-Figueroa, Íñigo, additional, Seror, Raphaèle, additional, Stummvoll, Georg H, additional, Tanaka, Yoshiya, additional, Tektonidou, Maria G, additional, Vasconcelos, Carlos, additional, Vital, Edward M, additional, Wallace, D J, additional, Yavuz, Sule, additional, Meroni, Pier Luigi, additional, Fritzler, Marvin J, additional, Naden, Ray, additional, Dörner, Thomas, additional, and Aringer, Martin, additional

Published
2020
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153. O8 Performance of the EULAR/ACR 2019 classification criteria for systemic lupus erythematosus in men, ethnicities, and early disease

Author

Aringer, Martin, primary, Brinks, Ralph, additional, Costenbader, Karen, additional, Boumpas, Dimitrios, additional, Daikh, David, additional, Jayne, David, additional, Kamen, Diane L, additional, Mosca, Marta, additional, Ramsey-Goldman, Rosalind, additional, Smolen, Josef S, additional, Wofsy, David, additional, Diamond, Betty, additional, Jacobsen, Søren, additional, Joseph McCune, W, additional, Ruiz-Irastorza, Guillermo, additional, Schneider, Matthias, additional, Urowitz, Murray, additional, Bertsias, George, additional, Hoyer, Bimba, additional, Leuchten, Nicolai, additional, Tani, Chiara, additional, Tedeschi, Sara K, additional, Touma, Zahi, additional, Anic, Branimir, additional, Assan, Florence, additional, Chan, Tak Mao, additional, Clarke, Ann E, additional, Crow, Peggy, additional, Czirjak, Lazlo, additional, Doria, Andrea, additional, Graninger, Winfried, additional, Halda-Kiss, Bernadette, additional, Hasni, Sarfaraz A, additional, Izmirly, Peter M, additional, Jung, Michelle, additional, Kumanovics, Gabor, additional, Mariette, Xavier, additional, Padjen, Ivan, additional, Pego-Reigosa, JM, additional, Romero-Díaz, Juanita, additional, Rúa-Figueroa, Iñigo, additional, Seror, Raphaele, additional, Stummvoll, Georg, additional, Tanaka, Yoshiya, additional, Tektonidou, Maria, additional, Vasconcelos, Carlos, additional, Vital, Edward M, additional, Wallace, Daniel J, additional, Yavuz, Sule, additional, Naden, Raymond P, additional, Dorner, Thomas, additional, and Johnson, Sindhu, additional

Published
2020
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154. Neuropsychiatric events in systemic lupus erythematosus: a longitudinal analysis of outcomes in an international inception cohort using a multistate model approach

Author

Hanly, John G, primary, Urowitz, Murray B, additional, Gordon, Caroline, additional, Bae, Sang-Cheol, additional, Romero-Diaz, Juanita, additional, Sanchez-Guerrero, Jorge, additional, Bernatsky, Sasha, additional, Clarke, Ann E, additional, Wallace, Daniel J, additional, Isenberg, David A, additional, Rahman, Anisur, additional, Merrill, Joan T, additional, Fortin, Paul R, additional, Gladman, Dafna D, additional, Bruce, Ian N, additional, Petri, Michelle, additional, Ginzler, Ellen M, additional, Dooley, Mary Anne, additional, Ramsey-Goldman, Rosalind, additional, Manzi, Susan, additional, Jönsen, Andreas, additional, Alarcón, Graciela S, additional, van Vollenhoven, Ronald F, additional, Aranow, Cynthia, additional, Mackay, Meggan, additional, Ruiz-Irastorza, Guillermo, additional, Lim, Sam, additional, Inanc, Murat, additional, Kalunian, Kenneth C, additional, Jacobsen, Søren, additional, Peschken, Christine A, additional, Kamen, Diane L, additional, Askanase, Anca, additional, and Farewell, Vernon, additional

Published
2020
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155. Soluble urokinase plasminogen activator receptor (suPAR) levels predict damage accrual in patients with recent-onset systemic lupus erythematosus

Author

Enocsson, Helena, primary, Wirestam, Lina, additional, Dahle, Charlotte, additional, Padyukov, Leonid, additional, Jönsen, Andreas, additional, Urowitz, Murray B., additional, Gladman, Dafna D., additional, Romero-Diaz, Juanita, additional, Bae, Sang-Cheol, additional, Fortin, Paul R., additional, Sanchez-Guerrero, Jorge, additional, Clarke, Ann E., additional, Bernatsky, Sasha, additional, Gordon, Caroline, additional, Hanly, John G., additional, Wallace, Daniel J., additional, Isenberg, David A., additional, Rahman, Anisur, additional, Merrill, Joan T., additional, Ginzler, Ellen, additional, Alarcón, Graciela S., additional, Chatham, W. Winn, additional, Petri, Michelle, additional, Khamashta, Munther, additional, Aranow, Cynthia, additional, Mackay, Meggan, additional, Dooley, Mary Anne, additional, Manzi, Susan, additional, Ramsey-Goldman, Rosalind, additional, Nived, Ola, additional, Steinsson, Kristjan, additional, Zoma, Asad A., additional, Ruiz-Irastorza, Guillermo, additional, Lim, S. Sam, additional, Kalunian, Kenneth C., additional, Inanc, Murat, additional, van Vollenhoven, Ronald F., additional, Ramos-Casals, Manuel, additional, Kamen, Diane L., additional, Jacobsen, Søren, additional, Peschken, Christine A., additional, Askanase, Anca, additional, Stoll, Thomas, additional, Bruce, Ian N., additional, Wetterö, Jonas, additional, and Sjöwall, Christopher, additional

Published
2020
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156. Peripheral Nervous System Disease in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study

Author

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

Published
2019
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157. High-density genotyping of STAT4 reveals multiple haplotypic associations with systemic lupus erythematosus in different racial groups

Author

Namjou, Bahram, Sestak, Andrea L., Armstrong, Don L., Zidovetzki, Raphael, Kelly, Jennifer A., Jacob, Noam, Ciobanu, Voicu, Kaufman, Kenneth M., Ojwang, Joshua O., Ziegler, Julie, Quismorio, Francesco P., Jr., Reiff, Andreas, Myones, Barry L., Guthridge, Joel M., Nath, Swapan K., Bruner, Gail R., Mehrian-Shai, Ruth, Silverman, Earl, Klein-Gitelman, Marisa, McCurdy, Deborah, Wagner-Weiner, Linda, Nocton, James J., Putterman, Chaim, Bae, Sang-Cheol, Kim, Yun Jung, Petri, Michelle, Reveille, John D., Vyse, Timothy J., Gilkeson, Gary S., Kamen, Diane L., Alarcón-Riquelme, Marta E., Gaffney, Patrick M., Moser, Kathy L., Merrill, Joan T., Scofield, Hal R., James, Judith A., Langefeld, Carl D., Harley, John B., and Jacob, Chaim O.

Published
2009
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159. Osteopontin versus disease activity and damage accrual in recent-onset systemic lupus erythematosus: Results from the Systemic Lupus International Collaborating Clinics Inception Cohort

Author

Wirestam, Lina, Enocsson, Helena, Skogh, Thomas, Padyukov, Leonid, Jönsen, Andreas, Urowitz, Murray, Gladman, Dafna, Romero-Diaz, Juanita, Bae, Sang-Cheol, Fortin, Paul R, Sanchez-Guerrero, Jorge, Clarke, Ann, Bernatsky, Sasha, Gordon, Caroline, Hanly, John G, Wallace, Daniel, Isenberg, David, Rahman, Anisur, Merrill, Joan, Ginzler, Ellen, Alarcón, Graciela S, Chatham, W Winn, Petri, Michelle, Khamashta, Munther, Aranow, Cynthia, Mackay, Meggan, Dooley, Mary Anne, Manzi, Susan, Ramsey-Goldman, Rosalind, Nived, Ola, Steinsson, Kristjan, Zoma, Asad, Ruiz-Irastorza, Guillermo, Lim, Sam, Kalunian, Ken, Inanc, Murat, van Vollenhoven, Ronald, Ramos-Casals, Manuel, Kamen, Diane L, Jacobsen, SØren, Peschken, Christine, Askanase, Anca, Stoll, Thomas, Bruce, Ian N, Wetterö, Jonas, and Sjöwall, Christopher

Subjects
Adult, Male, Asia, Internationality, Adolescent, Enzyme-Linked Immunosorbent Assay, Severity of Illness Index, Article, Young Adult, Sex Factors, stomatognathic system, Reference Values, Humans, Lupus Erythematosus, Systemic, skin and connective tissue diseases, Child, Aged, Age Factors, Middle Aged, Europe, Cross-Sectional Studies, Logistic Models, Multivariate Analysis, North America, Disease Progression, Female, Osteopontin, Biomarkers, Follow-Up Studies
Abstract

In cross-sectional studies, elevated osteopontin (OPN) levels have been proposed to reflect, and/or precede, progressive organ damage and disease severity in systemic lupus erythematosus (SLE). We aimed, in a cohort of patients with recent-onset SLE, to determine whether raised serum OPN levels precede damage and/or are associated with disease activity or certain disease phenotypes.We included 344 patients from the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort who had 5 years of followup data available. All patients fulfilled the 1997 American College of Rheumatology (ACR) criteria. Baseline sera from patients and from age- and sex-matched population-based controls were analyzed for OPN using ELISA. Disease activity and damage were assessed at each annual followup visit using the SLE Disease Activity Index 2000 (SLEDAI-2K) and the SLICC/ACR damage index (SDI), respectively.Compared to controls, baseline OPN was raised 4-fold in SLE cases (p0.0001). After relevant adjustments in a binary logistic regression model, OPN levels failed to significantly predict global damage accrual defined as SDI ≥ 1 at 5 years. However, baseline OPN correlated with SLEDAI-2K at enrollment into the cohort (r = 0.27, p0.0001), and patients with high disease activity (SLEDAI-2K ≥ 5) had raised serum OPN (p0.0001). In addition, higher OPN levels were found in patients with persistent disease activity (p = 0.0006), in cases with renal involvement (p0.0001) and impaired estimated glomerular filtration rate (p = 0.01).The performance of OPN to predict development of organ damage was not impressive. However, OPN associated significantly with lupus nephritis and with raised disease activity at enrollment, as well as over time.

Published
2019

161. Cell of origin in diffuse large B-cell lymphoma in systemic lupus erythematosus : molecular and clinical factors associated with survival

Author

Tessier-Cloutier, Basile, Twa, David D. W., Baecklund, Eva, Gascoyne, Randy, Johnson, Nathalie A., Backlin, Carin, Kamen, Diane L., Clarke, Ann E., Ramsey-Goldman, Rosalind, Lee, Jennifer L. F., Farinha, Pedro, Bernatsky, Sasha, Tessier-Cloutier, Basile, Twa, David D. W., Baecklund, Eva, Gascoyne, Randy, Johnson, Nathalie A., Backlin, Carin, Kamen, Diane L., Clarke, Ann E., Ramsey-Goldman, Rosalind, Lee, Jennifer L. F., Farinha, Pedro, and Bernatsky, Sasha

Abstract

Background SLE is associated with increased risk of diffuse large B-cell lymphoma (DLBCL). DLBCL is routinely classified by cell of origin (COO), with germinal centre B-cell (GCB) being more common and indicating better prognosis in the general population. We studied COO subtyping in patients with SLE diagnosed with DLBCL and their survival. Patients and methods We evaluated 20 cases of SLE with DLBCL. Immunohistochemistry analysis was performed (BCL2, MYC, BCL6, CD10, CD20, FOXP1, GCET1, MUM1) in tissue microarrays. We examined associations between molecular and clinical features, including overall survival. Results Of the 20 DLBCL SLE cases, 12/20 cases (60%) were classified as non-GCB using Hans or Choi algorithms. MYC and BCL2 protein expression was positive in 6/20 (30%) and 8/20 (40%) SLE cases, respectively, with 2/20 (10%) co-expressing both markers. Seven (7/20) had only extranodal involvement at DLBCL diagnosis. As expected, non-GCB cases had worse survival. Cases presenting exclusively with extranodal disease were associated with shorter SLE duration and better survival despite higher BCL2 protein expression. Conclusions We present novel data characterising DLBCL in SLE. Sixty per cent of the DLBCL in patients with SLE were non-GCB. The nodal and extranodal distribution in SLE was similar to what is known in the general population, but extranodal disease occurred more often with short SLE duration and was associated with longer overall survival. More research on cancer in SLE is the key to further understanding the complex interplay between cancer and the immune system.

Published
2019
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162. Low aspirin use and high prevalence of pre-eclampsia risk factors among pregnant women in a multinational SLE inception cohort

Author

Medicina, Medikuntza, Mendel, Arielle, Bernatsky, Sasha B., Hanly, John G., Urowitz, Murray B., Clarke, Ann Elaine, Romero Díaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Wallace, Daniel J., Merrill, Joan T., Buyon, Jill P., Isenberg, David A., Rahman, Anisur, Ginzler, Ellen M., Petri, Michelle, Dooley, Mary Anne, Fortin, Paul R., Gladman, Dafna D., Steinsson, Kristjan, Ramsey Goldman, Rosalind, Khamashta, Munther A., Aranow, Cynthia, Mackay, Meggan, Alarcon, Graciela S., Manzi, Susan, Nived, Ola, Jonsen, Andreas, Zoma, Asad A., Ramos Casals, Manuel, Ruiz Irastorza, Guillermo, Lim, Sam, Kalunian, Ken C., Inanc, Murat, Kamen, Diane L., Peschken, Christine A., Jacobsen, Soren, Askanase, Anca, Sánchez Guerrero, Jorge, Bruce, Ian N., Costedoat Chalumeau, Nathalie, Vinet, Evelyne, Medicina, Medikuntza, Mendel, Arielle, Bernatsky, Sasha B., Hanly, John G., Urowitz, Murray B., Clarke, Ann Elaine, Romero Díaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Wallace, Daniel J., Merrill, Joan T., Buyon, Jill P., Isenberg, David A., Rahman, Anisur, Ginzler, Ellen M., Petri, Michelle, Dooley, Mary Anne, Fortin, Paul R., Gladman, Dafna D., Steinsson, Kristjan, Ramsey Goldman, Rosalind, Khamashta, Munther A., Aranow, Cynthia, Mackay, Meggan, Alarcon, Graciela S., Manzi, Susan, Nived, Ola, Jonsen, Andreas, Zoma, Asad A., Ramos Casals, Manuel, Ruiz Irastorza, Guillermo, Lim, Sam, Kalunian, Ken C., Inanc, Murat, Kamen, Diane L., Peschken, Christine A., Jacobsen, Soren, Askanase, Anca, Sánchez Guerrero, Jorge, Bruce, Ian N., Costedoat Chalumeau, Nathalie, and Vinet, Evelyne

Published
2019

163. Soluble urokinase plasminogen activator receptor (suPAR) levels predict damage accrual in patients with recent-onset systemic lupus erythematosus

Author

Medicina, Medikuntza, Enocsson, Helena, Wirestam, Lina, Dahle, Charlotte, Padyukov, Leonid, Jonsen, Andreas, Urowitz, Murray B, Gladman, Dafna D, Romero Díaz, Juanita, Bae, Sang Cheol, Fortin, Paul R., Sánchez Guerrero, Jorge, Clarke, Ann E, Bernatsky, Sasha, Gordon, Caroline, Hanly, John G, Wallace, Daniel J., Isenberg, David A, Rahman, Anisur, Merrill, Joan T, Ginzler, Ellen, Alarcón, Graciela S, Chatham, W Winn, Petri, Michelle, Khamashta, Munther, Aranow, Cynthia, Mackay, Meggan, Dooley, Mary Anne, Manzi, Susan, Ramsey Goldman, Rosalind, Nived, Ola, Steinsson, Kristjan, Zoma, Asad A, Ruiz Irastorza, Guillermo, Lim, S Sam, Kalunian, Kenneth C, Inanc, Murat, van Vollenhoven, Ronald F, Ramos Casals, Manuel, Kamen, Diane L, Jacobsen, Soren, Peschken, Christine A, Askanase, Anca, Stoll, Thomas, Bruce, Ian N, Wettero, Jonas, Sjowall, Christopher, Medicina, Medikuntza, Enocsson, Helena, Wirestam, Lina, Dahle, Charlotte, Padyukov, Leonid, Jonsen, Andreas, Urowitz, Murray B, Gladman, Dafna D, Romero Díaz, Juanita, Bae, Sang Cheol, Fortin, Paul R., Sánchez Guerrero, Jorge, Clarke, Ann E, Bernatsky, Sasha, Gordon, Caroline, Hanly, John G, Wallace, Daniel J., Isenberg, David A, Rahman, Anisur, Merrill, Joan T, Ginzler, Ellen, Alarcón, Graciela S, Chatham, W Winn, Petri, Michelle, Khamashta, Munther, Aranow, Cynthia, Mackay, Meggan, Dooley, Mary Anne, Manzi, Susan, Ramsey Goldman, Rosalind, Nived, Ola, Steinsson, Kristjan, Zoma, Asad A, Ruiz Irastorza, Guillermo, Lim, S Sam, Kalunian, Kenneth C, Inanc, Murat, van Vollenhoven, Ronald F, Ramos Casals, Manuel, Kamen, Diane L, Jacobsen, Soren, Peschken, Christine A, Askanase, Anca, Stoll, Thomas, Bruce, Ian N, Wettero, Jonas, and Sjowall, Christopher

Abstract

OBJECTIVE: The soluble urokinase plasminogen activator receptor (suPAR) has potential as a prognosis and severity biomarker in several inflammatory and infectious diseases. In a previous cross-sectional study, suPAR levels were shown to reflect damage accrual in cases of systemic lupus erythematosus (SLE). Herein, we evaluated suPAR as a predictor of future organ damage in recent-onset SLE. METHODS: Included were 344 patients from the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort who met the 1997 American College of Rheumatology classification criteria with 5-years of follow-up data available. Baseline sera from patients and age- and sex-matched controls were assayed for suPAR. Organ damage was assessed annually using the SLICC/ACR damage index (SDI). RESULTS: The levels of suPAR were higher in patients who accrued damage, particularly those with SDI≥2 at 5 years (N = 32, 46.8% increase, p = 0.004), as compared to patients without damage. Logistic regression analysis revealed a significant impact of suPAR on SDI outcome (SDI≥2; OR = 1.14; 95% CI 1.03-1.26), also after adjustment for confounding factors. In an optimized logistic regression to predict damage, suPAR persisted as a predictor, together with baseline disease activity (SLEDAI-2K), age, and non-Caucasian ethnicity (model AUC = 0.77). Dissecting SDI into organ systems revealed higher suPAR levels in patients who developed musculoskeletal damage (SDI≥1; p = 0.007). CONCLUSION: Prognostic biomarkers identify patients who are at risk of acquiring early damage and therefore need careful observation and targeted treatment strategies. Overall, suPAR constitutes an interesting biomarker for patient stratification and for identifying SLE patients who are at risk of acquiring organ damage during the first 5 years of disease.

Published
2019

164. Osteopontin and Disease Activity in Patients with Recent-onset Systemic Lupus Erythematosus:Results from the SLICC Inception Cohort

Author

Wirestam, Lina, Enocsson, Helena, Skogh, Thomas, Padyukov, Leonid, Jönsen, Andreas, Urowitz, Murray B, Gladman, Dafna D, Romero-Diaz, Juanita, Bae, Sang-Cheol, Fortin, Paul R, Sanchez-Guerrero, Jorge, Clarke, Ann E, Bernatsky, Sasha, Gordon, Caroline, Hanly, John G, Wallace, Daniel, Isenberg, David A, Rahman, Anisur, Merrill, Joan, Ginzler, Ellen, Alarcón, Graciela S, Chatham, W Winn, Petri, Michelle, Khamashta, Munther, Aranow, Cynthia, Mackay, Meggan, Dooley, Mary Anne, Manzi, Susan, Ramsey-Goldman, Rosalind, Nived, Ola, Steinsson, Kristjan, Zoma, Asad, Ruiz-Irastorza, Guillermo, Lim, Sam, Kalunian, Ken, Inanc, Murat, van Vollenhoven, Ronald, Ramos-Casals, Manuel, Kamen, Diane L, Jacobsen, Søren, Peschken, Christine, Askanase, Anca, Stoll, Thomas, Bruce, Ian N, Wetterö, Jonas, Sjöwall, Christopher, Wirestam, Lina, Enocsson, Helena, Skogh, Thomas, Padyukov, Leonid, Jönsen, Andreas, Urowitz, Murray B, Gladman, Dafna D, Romero-Diaz, Juanita, Bae, Sang-Cheol, Fortin, Paul R, Sanchez-Guerrero, Jorge, Clarke, Ann E, Bernatsky, Sasha, Gordon, Caroline, Hanly, John G, Wallace, Daniel, Isenberg, David A, Rahman, Anisur, Merrill, Joan, Ginzler, Ellen, Alarcón, Graciela S, Chatham, W Winn, Petri, Michelle, Khamashta, Munther, Aranow, Cynthia, Mackay, Meggan, Dooley, Mary Anne, Manzi, Susan, Ramsey-Goldman, Rosalind, Nived, Ola, Steinsson, Kristjan, Zoma, Asad, Ruiz-Irastorza, Guillermo, Lim, Sam, Kalunian, Ken, Inanc, Murat, van Vollenhoven, Ronald, Ramos-Casals, Manuel, Kamen, Diane L, Jacobsen, Søren, Peschken, Christine, Askanase, Anca, Stoll, Thomas, Bruce, Ian N, Wetterö, Jonas, and Sjöwall, Christopher

Abstract

OBJECTIVE: In cross-sectional studies, elevated osteopontin (OPN) levels have been proposed to reflect, and/or precede, progressive organ damage and disease severity in systemic lupus erythematosus (SLE). We aimed, in a cohort of patients with recent-onset SLE, to determine whether raised serum OPN levels precede damage and/or are associated with disease activity or certain disease phenotypes.METHODS: We included 344 patients from the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort who had 5 years of followup data available. All patients fulfilled the 1997 American College of Rheumatology (ACR) criteria. Baseline sera from patients and from age- and sex-matched population-based controls were analyzed for OPN using ELISA. Disease activity and damage were assessed at each annual followup visit using the SLE Disease Activity Index 2000 (SLEDAI-2K) and the SLICC/ACR damage index (SDI), respectively.RESULTS: Compared to controls, baseline OPN was raised 4-fold in SLE cases (p < 0.0001). After relevant adjustments in a binary logistic regression model, OPN levels failed to significantly predict global damage accrual defined as SDI ≥ 1 at 5 years. However, baseline OPN correlated with SLEDAI-2K at enrollment into the cohort (r = 0.27, p < 0.0001), and patients with high disease activity (SLEDAI-2K ≥ 5) had raised serum OPN (p < 0.0001). In addition, higher OPN levels were found in patients with persistent disease activity (p = 0.0006), in cases with renal involvement (p < 0.0001) and impaired estimated glomerular filtration rate (p = 0.01).CONCLUSION: The performance of OPN to predict development of organ damage was not impressive. However, OPN associated significantly with lupus nephritis and with raised disease activity at enrollment, as well as over time.

Published
2019

165. Psychosis 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, M A, Steinsson, Kristjan, Ramsey-Goldman, Rosalind, Zoma, Asad A, Manzi, Susan, Nived, Ola, Jonsen, Andreas, Khamashta, Munther A, Alarcón, Graciela S, van Vollenhoven, Ronald F, Aranow, Cynthia, Mackay, Meggan, Ruiz-Irastorza, Guillermo, Ramos-Casals, Manuel, Lim, S Sam, Inanc, Murat, Kalunian, Kenneth C, Jacobsen, Søren, Peschken, Christine A, Kamen, Diane L, Askanase, Anca, Theriault, Chris, Farewell, Vernon, 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, M A, Steinsson, Kristjan, Ramsey-Goldman, Rosalind, Zoma, Asad A, Manzi, Susan, Nived, Ola, Jonsen, Andreas, Khamashta, Munther A, Alarcón, Graciela S, van Vollenhoven, Ronald F, Aranow, Cynthia, Mackay, Meggan, Ruiz-Irastorza, Guillermo, Ramos-Casals, Manuel, Lim, S Sam, Inanc, Murat, Kalunian, Kenneth C, Jacobsen, Søren, Peschken, Christine A, Kamen, Diane L, Askanase, Anca, Theriault, Chris, and Farewell, Vernon

Abstract

OBJECTIVE: To determine, in a large, multiethnic/multiracial, prospective inception cohort of patients with systemic lupus erythematosus (SLE), the frequency, attribution, clinical, and autoantibody associations with lupus psychosis and the short- and long-term outcomes as assessed by physicians and patients.METHODS: Patients were evaluated annually for 19 neuropsychiatric (NP) events including psychosis. Scores on the Systemic Lupus Erythematosus Disease Activity Index 2000, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, and the Short Form 36 (SF-36) were recorded. Time to event and linear regressions were used as appropriate.RESULTS: Of 1,826 SLE patients, 88.8% were female and 48.8% were Caucasian. The mean ± SD age was 35.1 ± 13.3 years, the mean ± SD disease duration was 5.6 ± 4.2 months, and the mean ± SD follow-up period was 7.4 ± 4.5 years. There were 31 psychotic events in 28 of 1,826 patients (1.53%), and most patients had a single event (26 of 28 [93%]). In the majority of patients (20 of 25 [80%]) and events (28 of 31 [90%]), psychosis was attributed to SLE, usually either in the year prior to or within 3 years of SLE diagnosis. Positive associations (hazard ratios [HRs] and 95% confidence intervals [95% CIs]) with lupus psychosis were previous SLE NP events (HR 3.59 [95% CI 1.16-11.14]), male sex (HR 3.0 [95% CI 1.20-7.50]), younger age at SLE diagnosis (per 10 years) (HR 1.45 [95% CI 1.01-2.07]), and African ancestry (HR 4.59 [95% CI 1.79-11.76]). By physician assessment, most psychotic events resolved by the second annual visit following onset, in parallel with an improvement in patient-reported SF-36 summary and subscale scores.CONCLUSION: Psychosis is an infrequent manifestation of NPSLE. Generally, it occurs early after SLE onset and has a significant negative impact on health status. As determined by patient and physician report, the short- and long-term outlooks are go

Published
2019

166. Multicriteria decision analysis process to develop new classification criteria for systemic lupus erythematosus

Author

Tedeschi, Sara K., Johnson, Sindhu R., Boumpas, Dimitrios T., Daikh, David, Dörner, Thomas, Diamond, Betty, Jacobsen, Søren, Jayne, David, Kamen, Diane L., McCune, W. Joseph, Mosca, Marta, Ramsey-Goldman, Rosalind, Ruiz-Irastorza, Guillermo, Schneider, Matthias, Urowitz, Murray, Wofsy, David, Smolen, Josef S., Naden, Raymond P., Aringer, Martin, Costenbader, Karen H., Tedeschi, Sara K., Johnson, Sindhu R., Boumpas, Dimitrios T., Daikh, David, Dörner, Thomas, Diamond, Betty, Jacobsen, Søren, Jayne, David, Kamen, Diane L., McCune, W. Joseph, Mosca, Marta, Ramsey-Goldman, Rosalind, Ruiz-Irastorza, Guillermo, Schneider, Matthias, Urowitz, Murray, Wofsy, David, Smolen, Josef S., Naden, Raymond P., Aringer, Martin, and Costenbader, Karen H.

Abstract

European League Against Rheumatism and are jointly supporting multiphase development of systemic lupus erythematosus (SLE) classification criteria based on weighted criteria and a continuous probability scale. Prior steps included item generation, item reduction and hierarchical organisation of candidate criteria using an evidence-based approach. Our objectives were to determine relative weights using multicriteria decision analysis (MCDA) and to set a provisional threshold score for SLE classification. An SLE Expert Panel (8 European, 9 North American) submitted 164 real, unique cases with a wide range of SLE probability in a standardised format. Using the candidate criteria, experts scored and rank-ordered 20 representative cases. At an in-person meeting, experts reviewed inter-rater reliability of scoring, further refined criteria definitions and participated in an MCDA exercise. Based on expert consensus decisions on pairwise comparisons of criteria, 1000minds software calculated criteria weights and rank-ordered the remaining 144 cases based on their additive scores. The score of the lowest-ranked case for which complete expert consensus was achieved defined the provisional threshold classification score. Inter-rater reliability of scoring cases with the candidate criteria was good. MCDA involved 74 pairwise decisions and was repeated for the arthritis and mucocutaneous domains when the initial ranking of some cases did not match expert opinion. After criteria weights and additive scores were recalculated once, experts reached consensus for SLE classification for all cases scoring>83. Using an iterative process, the candidate criteria definitions were refined, preliminary weights were calculated and a provisional threshold score for SLE classification was determined.

Published
2019

167. Low aspirin use and high prevalence of pre-eclampsia risk factors among pregnant women in a multinational SLE inception cohort

Author

Mendel, Arielle, Bernatsky, Sasha B., Hanly, John G., Urowitz, Murray B., Clarke, Ann Elaine, Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang Cheol, Wallace, Daniel J., Merrill, Joan T., Buyon, Jill P., Isenberg, David A., Rahman, Anisur, Ginzler, Ellen M., Petri, Michelle, Dooley, Mary Anne, Fortin, Paul R., Gladman, Dafna D., Steinsson, Kristján, 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, Sam, Kalunian, Ken C., Inanc, Murat, Kamen, Diane L., Peschken, Christine A., Jacobsen, Søren, Askanase, Anca, Sanchez-Guerrero, Jorge, Bruce, Ian N., Costedoat-Chalumeau, Nathalie, Vinet, Évelyne, Mendel, Arielle, Bernatsky, Sasha B., Hanly, John G., Urowitz, Murray B., Clarke, Ann Elaine, Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang Cheol, Wallace, Daniel J., Merrill, Joan T., Buyon, Jill P., Isenberg, David A., Rahman, Anisur, Ginzler, Ellen M., Petri, Michelle, Dooley, Mary Anne, Fortin, Paul R., Gladman, Dafna D., Steinsson, Kristján, 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, Sam, Kalunian, Ken C., Inanc, Murat, Kamen, Diane L., Peschken, Christine A., Jacobsen, Søren, Askanase, Anca, Sanchez-Guerrero, Jorge, Bruce, Ian N., Costedoat-Chalumeau, Nathalie, and Vinet, Évelyne

Published
2019

168. Cerebrovascular Events in Systemic Lupus Erythematosus

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, M. A., 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, Farewell, Vernon, AII - Inflammatory diseases, Clinical Immunology and Rheumatology, AMS - Amsterdam Movement Sciences, and AII - Amsterdam institute for Infection and Immunity

Abstract

To determine the frequency, associations and outcomes of cerebrovascular events (CerVEs) in a multi-ethnic/racial, prospective, SLE disease inception cohort. Patients were assessed annually for 19 neuropsychiatric (NP) events including 5 types of CerVEs: (i) Stroke; (ii) Transient ischemia; (iii) Chronic multifocal ischemia; (iv) Subarachnoid/intracranial hemorrhage; (v) Sinus thrombosis. Global disease activity (SLEDAI-2K), SLICC/ACR damage index (SDI) and SF-36 scores were collected. Time to event, linear and logistic regressions and multi-state models were used as appropriate. Of 1,826 SLE patients, 88.8% were female, 48.8% Caucasian, mean±SD age 35.1±13.3 years, disease duration 5.6±4.2 months and follow-up 6.6±4.1 years. CerVEs were the fourth most frequent NP event: 82/1,826 (4.5%) patients had 109 events, 103/109 (94.5%) were attributed to SLE and 44/109 (40.4%) were identified at enrollment. The predominant events were stroke [60/109 (55.0%)] and transient ischemia [28/109 (25.7%)]. CerVEs were associated with other NP events attributed to SLE (HR (95% CI): (3.16; 1.73-5.75) (p

Published
2018

169. A Link Between Plasma Microbial Translocation, Microbiome, and Autoantibody Development in First‐Degree Relatives of Systemic Lupus Erythematosus Patients

Author

Ogunrinde, Elizabeth, primary, Zhou, Zejun, additional, Luo, Zhenwu, additional, Alekseyenko, Alexander, additional, Li, Quan‐Zhen, additional, Macedo, Danielle, additional, Kamen, Diane L., additional, Oates, Jim C., additional, Gilkeson, Gary S., additional, and Jiang, Wei, additional

Published
2019
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171. 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus

Author

Aringer, Martin, primary, Costenbader, Karen, additional, Daikh, David, additional, Brinks, Ralph, additional, Mosca, Marta, additional, Ramsey‐Goldman, Rosalind, additional, Smolen, Josef S., additional, Wofsy, David, additional, Boumpas, Dimitrios T., additional, Kamen, Diane L., additional, Jayne, David, additional, Cervera, Ricard, additional, Costedoat‐Chalumeau, Nathalie, additional, Diamond, Betty, additional, Gladman, Dafna D., additional, Hahn, Bevra, additional, Hiepe, Falk, additional, Jacobsen, Søren, additional, Khanna, Dinesh, additional, Lerstrøm, Kirsten, additional, Massarotti, Elena, additional, McCune, Joseph, additional, Ruiz‐Irastorza, Guillermo, additional, Sanchez‐Guerrero, Jorge, additional, Schneider, Matthias, additional, Urowitz, Murray, additional, Bertsias, George, additional, Hoyer, Bimba F., additional, Leuchten, Nicolai, additional, Tani, Chiara, additional, Tedeschi, Sara K., additional, Touma, Zahi, additional, Schmajuk, Gabriela, additional, Anic, Branimir, additional, Assan, Florence, additional, Chan, Tak Mao, additional, Clarke, Ann Elaine, additional, Crow, Mary K., additional, Czirják, László, additional, Doria, Andrea, additional, Graninger, Winfried, additional, Halda‐Kiss, Bernadett, additional, Hasni, Sarfaraz, additional, Izmirly, Peter M., additional, Jung, Michelle, additional, Kumánovics, Gábor, additional, Mariette, Xavier, additional, Padjen, Ivan, additional, Pego‐Reigosa, José M., additional, Romero‐Diaz, Juanita, additional, Rúa‐Figueroa Fernández, Íñigo, additional, Seror, Raphaèle, additional, Stummvoll, Georg H., additional, Tanaka, Yoshiya, additional, Tektonidou, Maria G., additional, Vasconcelos, Carlos, additional, Vital, Edward M., additional, Wallace, Daniel J., additional, Yavuz, Sule, additional, Meroni, Pier Luigi, additional, Fritzler, Marvin J., additional, Naden, Ray, additional, Dörner, Thomas, additional, and Johnson, Sindhu R., additional

Published
2019
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172. Association of Epstein-Barr virus serological reactivation with transitioning to systemic lupus erythematosus in at-risk individuals

Author

Jog, Neelakshi R, primary, Young, Kendra A, additional, Munroe, Melissa E, additional, Harmon, Michael T, additional, Guthridge, Joel M, additional, Kelly, Jennifer A, additional, Kamen, Diane L, additional, Gilkeson, Gary S, additional, Weisman, Michael H, additional, Karp, David R, additional, Gaffney, Patrick M, additional, Harley, John B, additional, Wallace, Daniel J, additional, Norris, Jill M, additional, and James, Judith A, additional

Published
2019
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173. Antinuclear Antibody–Negative Systemic Lupus Erythematosus in an International Inception Cohort

Author

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

Published
2019
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174. Progesterone decreases gut permeability through upregulating occludin expression in primary human gut tissues and Caco-2 cells

Author

Zhou, Zejun, primary, Bian, Chuanxiu, additional, Luo, Zhenwu, additional, Guille, Constance, additional, Ogunrinde, Elizabeth, additional, Wu, Jiapeng, additional, Zhao, Min, additional, Fitting, Sylvia, additional, Kamen, Diane L., additional, Oates, Jim C., additional, Gilkeson, Gary, additional, and Jiang, Wei, additional

Published
2019
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175. OP0252 NEUROPATHIES IN SYSTEMIC LUPUS ERYTHEMATOSUS: RESULTS FROM AN INTERNATIONAL, INCEPTION COHORT STUDY

Author

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

Published
2019
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176. Evaluating the Properties of a Frailty Index and Its Association With Mortality Risk Among Patients With Systemic Lupus Erythematosus

Author

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

Published
2019
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177. Cell of origin in diffuse large B-cell lymphoma in systemic lupus erythematosus: molecular and clinical factors associated with survival

Author

Tessier-Cloutier, Basile, primary, Twa, David DW, additional, Baecklund, Eva, additional, Gascoyne, Randy, additional, Johnson, Nathalie A, additional, Backlin, Carin, additional, Kamen, Diane L, additional, Clarke, Ann E, additional, Ramsey-Goldman, Rosalind, additional, Lee, Jennifer LF, additional, Farinha, Pedro, additional, and Bernatsky, Sasha, additional

Published
2019
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178. Construction of a Frailty Index as a Novel Health Measure in Systemic Lupus Erythematosus

Author

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

Published
2019
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180. Use of combined hormonal contraceptives among women with systemic lupus erythematosus with and without medical contraindications to oestrogen

Author

Mendel, Arielle, primary, Bernatsky, Sasha, additional, Pineau, Christian A, additional, St-Pierre, Yvan, additional, Hanly, John G, additional, Urowitz, Murray B, additional, Clarke, Ann E, additional, Romero-Diaz, Juanita, additional, Gordon, Caroline, additional, Bae, Sang-Cheol, additional, Wallace, Daniel J, additional, Merrill, Joan T, additional, Buyon, Jill, additional, Isenberg, David A, additional, Rahman, Anisur, additional, Ginzler, Ellen M, additional, Petri, Michelle, additional, Dooley, Mary Anne, additional, Fortin, Paul, additional, Gladman, Dafna D, additional, Steinsson, Kristján, additional, Ramsey-Goldman, Rosalind, additional, Khamashta, Munther A, additional, Aranow, Cynthia, additional, Mackay, Meggan, additional, Alarcón, Graciela, additional, Manzi, Susan, additional, Nived, Ola, additional, Jönsen, Andreas, additional, Zoma, Asad A, additional, van Vollenhoven, Ronald F, additional, Ramos-Casals, Manuel, additional, Ruiz-Irastorza, Giuillermo, additional, Lim, Sam, additional, Kalunian, Kenneth C, additional, Inanc, Murat, additional, Kamen, Diane L, additional, Peschken, Christine A, additional, Jacobsen, Søren, additional, Askanase, Anca, additional, Sanchez-Guerrero, Jorge, additional, Bruce, Ian N, additional, Costedoat-Chalumeau, Nathalie, additional, and Vinet, Evelyne, additional

Published
2019
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181. Multicriteria decision analysis process to develop new classification criteria for systemic lupus erythematosus

Author

Tedeschi, Sara K, primary, Johnson, Sindhu R, additional, Boumpas, Dimitrios T, additional, Daikh, David, additional, Dörner, Thomas, additional, Diamond, Betty, additional, Jacobsen, Søren, additional, Jayne, David, additional, Kamen, Diane L, additional, McCune, W Joseph, additional, Mosca, Marta, additional, Ramsey-Goldman, Rosalind, additional, Ruiz-Irastorza, Guillermo, additional, Schneider, Matthias, additional, Urowitz, Murray, additional, Wofsy, David, additional, Smolen, Josef S, additional, Naden, Raymond P, additional, Aringer, Martin, additional, and Costenbader, Karen H, additional

Published
2019
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182. Psychosis in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study

Author

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

Published
2019
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183. Osteopontin and Disease Activity in Patients with Recent-onset Systemic Lupus Erythematosus: Results from the SLICC Inception Cohort

Author

Wirestam, Lina, primary, Enocsson, Helena, additional, Skogh, Thomas, additional, Padyukov, Leonid, additional, Jönsen, Andreas, additional, Urowitz, Murray B., additional, Gladman, Dafna D., additional, Romero-Diaz, Juanita, additional, Bae, Sang-Cheol, additional, Fortin, Paul R., additional, Sanchez-Guerrero, Jorge, additional, Clarke, Ann E., additional, Bernatsky, Sasha, additional, Gordon, Caroline, additional, Hanly, John G., additional, Wallace, Daniel, additional, Isenberg, David A., additional, Rahman, Anisur, additional, Merrill, Joan, additional, Ginzler, Ellen, additional, Alarcón, Graciela S., additional, Chatham, W. Winn, additional, Petri, Michelle, additional, Khamashta, Munther, additional, Aranow, Cynthia, additional, Mackay, Meggan, additional, Dooley, Mary Anne, additional, Manzi, Susan, additional, Ramsey-Goldman, Rosalind, additional, Nived, Ola, additional, Steinsson, Kristjan, additional, Zoma, Asad, additional, Ruiz-Irastorza, Guillermo, additional, Lim, Sam, additional, Kalunian, Ken, additional, Inanc, Murat, additional, van Vollenhoven, Ronald, additional, Ramos-Casals, Manuel, additional, Kamen, Diane L., additional, Jacobsen, Søren, additional, Peschken, Christine, additional, Askanase, Anca, additional, Stoll, Thomas, additional, Bruce, Ian N., additional, Wetterö, Jonas, additional, and Sjöwall, Christopher, additional

Published
2019
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184. Low aspirin use and high prevalence of pre-eclampsia risk factors among pregnant women in a multinational SLE inception cohort

Author

Mendel, Arielle, primary, Bernatsky, Sasha B, additional, Hanly, John G, additional, Urowitz, Murray B, additional, Clarke, Ann Elaine, additional, Romero-Diaz, Juanita, additional, Gordon, Caroline, additional, Bae, Sang-Cheol, additional, Wallace, Daniel J, additional, Merrill, Joan T, additional, Buyon, Jill P, additional, Isenberg, David A, additional, Rahman, Anisur, additional, Ginzler, Ellen M, additional, Petri, Michelle, additional, Dooley, Mary Anne, additional, Fortin, Paul R, additional, Gladman, Dafna D, additional, Steinsson, Kristján, additional, Ramsey-Goldman, Rosalind, additional, Khamashta, Munther A, additional, Aranow, Cynthia, additional, Mackay, Meggan, additional, Alarcón, Graciela S, additional, Manzi, Susan, additional, Nived, Ola, additional, Jönsen, Andreas, additional, Zoma, Asad A, additional, van Vollenhoven, Ronald F, additional, Ramos-Casals, Manuel, additional, Ruiz-Irastorza, Guillermo, additional, Lim, Sam, additional, Kalunian, Ken C, additional, Inanc, Murat, additional, Kamen, Diane L, additional, Peschken, Christine A, additional, Jacobsen, Søren, additional, Askanase, Anca, additional, Sanchez-Guerrero, Jorge, additional, Bruce, Ian N, additional, Costedoat-Chalumeau, Nathalie, additional, and Vinet, Évelyne, additional

Published
2018
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185. Use of Consensus Methodology to Determine Candidate Items for Systemic Lupus Erythematosus Classification Criteria

Author

Johnson, Sindhu R., primary, Khanna, Dinesh, additional, Daikh, David, additional, Cervera, Ricard, additional, Costedoat-Chalumeau, Nathalie, additional, Gladman, Dafna D., additional, Hahn, Bevra H., additional, Hiepe, Falk, additional, Sánchez-Guerrero, Jorge, additional, Massarotti, Elena, additional, Boumpas, Dimitrios T., additional, Costenbader, Karen H., additional, Jayne, David, additional, Dörner, Thomas, additional, Kamen, Diane L., additional, Mosca, Marta, additional, Ramsey-Goldman, Rosalind, additional, Smolen, Josef S., additional, Wofsy, David, additional, and Aringer, Martin, additional

Published
2018
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187. Cancer Risk in a Large Inception Systemic Lupus Erythematosus Cohort: Effects of Demographic Characteristics, Smoking, and Medications

Author

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

Abstract

To assess cancer risk factors in incident systemic lupus erythematosus (SLE). Clinical variables and cancer outcomes were assessed annually among incident SLE patients. Multivariate hazard regression models (overall risk and most common cancers) included demographic characteristics and time‐dependent medications (corticosteroids, antimalarial drugs, immunosuppressants), smoking, and the adjusted mean Systemic Lupus Erythematosus Disease Activity Index 2000 score. Among 1,668 patients (average 9 years follow‐up), 65 cancers occurred: 15 breast, 10 nonmelanoma skin, 7 lung, 6 hematologic, 6 prostate, 5 melanoma, 3 cervical, 3 renal, 2 each gastric, head and neck, and thyroid, and 1 each rectal, sarcoma, thymoma, and uterine cancers. Half of the cancers (including all lung cancers) occurred in past/current smokers, versus one‐third of patients without cancer. Multivariate analyses indicated that overall cancer risk was related primarily to male sex and older age at SLE diagnosis. In addition, smoking was associated with lung cancer. For breast cancer risk, age was positively associated and antimalarial drugs were negatively associated. Antimalarial drugs and higher disease activity were also negatively associated with nonmelanoma skin cancer risk, whereas age and cyclophosphamide were positively associated. Disease activity was associated positively with hematologic and negatively with nonmelanoma skin cancer risk. Smoking is a key modifiable risk factor, especially for lung cancer, in SLE. Immunosuppressive medications were not clearly associated with higher risk except for cyclophosphamide and nonmelanoma skin cancer. Antimalarials were negatively associated with breast cancer and nonmelanoma skin cancer risk. SLE activity was associated positively with hematologic cancer and negatively with nonmelanoma skin cancer. Since the absolute number of cancers was small, additional follow‐up will help consolidate these findings.

Published
2021
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188. Genetic Determinants of Lupus Nephritis and Kidney Function in Systemic Lupus Erythematosus

Author

Khursigara, Magdalena Riedl, Gold, Nicholas, Dominguez, Daniela, Levy, Deborah, Noone, Damien G., Cao, Jingjing, Urowitz, Murray B., Onel, Karen S., Harvey, Elizabeth A., Lee, Chia-Chi J., Jefferies, Caroline, Wither, Joan, Kamen, Diane L., Pope, Janet, Peschken, Christine A., Petri, Michelle, Goldman, Daniel W., Tang, Thai-Son, Ishimori, Mariko, Knight, Andrea, Silverman, Earl, and Hiraki, Linda T.

Published
2023
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189. An Analysis of Cell-of-Origin in Diffuse Large B-Cell Lymphoma in Systemic Lupus Erythematosus, Including Molecular and Clinical Factors Associated with Survival

Author

Tessier-Cloutier, Basile, Twa, David, Baecklund, Eva, Gascoyne, Randy, Johnson, Nathalie A., Backlin, Carin, Kamen, Diane L., Clarke, Ann E., Ramsey-Goldman, Rosalind, Lee, Jennifer L. F., Farinha, Pedro, Bernatsky, Sasha, Tessier-Cloutier, Basile, Twa, David, Baecklund, Eva, Gascoyne, Randy, Johnson, Nathalie A., Backlin, Carin, Kamen, Diane L., Clarke, Ann E., Ramsey-Goldman, Rosalind, Lee, Jennifer L. F., Farinha, Pedro, and Bernatsky, Sasha

Published
2018

190. Glucocorticoid use and factors associated with variability in this use in the Systemic Lupus International Collaborating Clinics Inception Cohort.

Author

Little, Jayne, Little, Jayne, Parker, Ben, Lunt, Mark, Hanly, John G, Urowitz, Murray B, Clarke, Ann E, Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Bernatsky, Sasha, Wallace, Daniel J, Merrill, Joan T, Buyon, Jill, Isenberg, David A, Rahman, Anisur, Ginzler, Ellen M, Petri, Michelle, Dooley, Mary Anne, Fortin, Paul, Gladman, Dafna D, Steinsson, Kristjan, 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, Sam Lim, Sung, Kalunian, Kenneth C, Inanc, Murat, Kamen, Diane L, Peschken, Christine A, Jacobsen, Soren, Askanase, Anca, Sanchez-Guerrero, Jorge, Bruce, Ian N, Little, Jayne, Little, Jayne, Parker, Ben, Lunt, Mark, Hanly, John G, Urowitz, Murray B, Clarke, Ann E, Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Bernatsky, Sasha, Wallace, Daniel J, Merrill, Joan T, Buyon, Jill, Isenberg, David A, Rahman, Anisur, Ginzler, Ellen M, Petri, Michelle, Dooley, Mary Anne, Fortin, Paul, Gladman, Dafna D, Steinsson, Kristjan, 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, Sam Lim, Sung, Kalunian, Kenneth C, Inanc, Murat, Kamen, Diane L, Peschken, Christine A, Jacobsen, Soren, Askanase, Anca, Sanchez-Guerrero, Jorge, and Bruce, Ian N

Abstract

ObjectivesTo describe glucocorticoid (GC) use in the SLICC inception cohort and to explore factors associated with GC use. In particular we aimed to assess temporal trends in GC use and to what extent physician-related factors may influence use.MethodsPatients were recruited within 15 months of diagnosis of SLE from 33 centres between 1999 and 2011 and continue to be reviewed annually. Descriptive statistics were used to detail oral and parenteral GC use. Cross sectional and longitudinal analyses were performed to explore factors associated with GC use at enrolment and over time.ResultsWe studied 1700 patients with a mean (s.d.) follow-up duration of 7.26 (3.82) years. Over the entire study period, 1365 (81.3%) patients received oral GCs and 447 (26.3%) received parenteral GCs at some point. GC use was strongly associated with treatment centre, age, race/ethnicity, sex, disease duration and disease activity. There was no change in the proportion of patients on GCs or the average doses of GC used over time according to year of diagnosis.ConclusionGCs remain a cornerstone in SLE management and there have been no significant changes in their use over the past 10-15 years. While patient and disease factors contribute to the variation in GC use, between-centre differences suggest that physician-related factors also contribute. Evidence-based treatment algorithms are needed to inform a more standardized approach to GC use in SLE.

Published
2018

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

Author

Barber, Megan RW, 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, Clarke, Ann E, Barber, Megan RW, 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

Abstract

ObjectiveLittle is known about the long-term costs of lupus nephritis (LN). The costs were compared between patients with and without LN using multistate modeling.MethodsPatients 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.ResultsA 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) <30 ml/minute ($310,579 2015 Canadian dollars versus $19,987 if no LN and estimated GFR >60 ml/minute) or with LN and estimated proteinuria >3 gm/day ($84,040 versus $20,499 if no LN and estimated proteinuria <0.25 gm/day).ConclusionPatients with estimated GFR <30 ml/minute incurred 10-year costs 15-fold higher than those with normal estimated GFR. By estimating the expected duration in each renal state and incorporating associated annual costs, disease severity at presentation can be used to anticipate future health care costs. This is critical knowledge for cost-effectiveness evaluations of novel therapies.

Published
2018

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

Author

Hanly, John G, 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, Farewell, Vernon, Hanly, John G, 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

Abstract

ObjectiveTo 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).MethodsA 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.ResultsCerVEs 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.ConclusionCerVEs, 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.

Published
2018

193. Cultural and quality-of-life considerations when administering corticosteroids as a therapeutic strategy for African American women living with systemic lupus erythematosus

Author

Applyrs,Dorcey L, Williams,Edith M, Faith,Trevor D, Kamen,Diane L, Vazquez,Elizabeth, Jurkowski,Janine, Applyrs,Dorcey L, Williams,Edith M, Faith,Trevor D, Kamen,Diane L, Vazquez,Elizabeth, and Jurkowski,Janine

Abstract

Dorcey L Applyrs,1 Edith M Williams,2 Trevor D Faith,2 Diane L Kamen,3 Elizabeth Vazques,4 Janine M Jurkowski5 1School of Health Sciences, Excelsior College, Albany, NY, USA; 2Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA; 3Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC, USA; 4Department of Epidemiology and Biostatistics, State University of New York at Albany, One University Place, Rensselaer, NY, USA; 5Department of Health Policy, Management, and Behavior, State University of New York at Albany, One University Place, Rensselaer, NY, USA Objective: This study investigated the association among corticosteroids, emotional health, physical health, and work/regular activities of daily living in an ethnically diverse sample of women with systemic lupus erythematosus.Methods: A secondary analysis of data from the Medical University of South Carolina Lupus Database was conducted between confirmed cases of lupus (n = 224) and controls (n = 60). The sample comprised 57 Caucasian Americans, 141 Gullah African Americans (a subpopulation of African Americans from the Sea Islands of South Carolina and Georgia), and 86 non-Gullah African Americans.Results: Emotional health outcomes were better for women with systemic lupus erythematosus compared with controls. High emotional health scores may be influenced by cultural factors such as masking emotion, disease-coping mechanisms, religion, and strong familial and social support. Although a significant association was not detected between emotional health and work/regular activities of daily living, relationships were significant after adjusting for corticosteroid use.Conclusion: These findings suggest corticosteroid use does influence the strength of the association between emotional health and work/regular activities of daily living. Keywords: systemic lupus erythematosus, emotional health, physical health, Gullah, corticosteroids, qua

Published
2018

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

Author

Barber, Megan R W, 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, Clarke, Ann E, Barber, Megan R W, 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

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) <30 ml/minute ($310,579 2015 Canadian dollars versus $19,987 if no LN and estimated GFR >60 ml/minute) or with LN and estimated proteinuria >3 gm/day ($84,040 versus $20,499 if no LN and estimated proteinuria <0.25 gm/day).CONCLUSION: Patients with estimated GFR <30 ml/minute incurred 10-year costs 15-fold higher than those with normal estimated GFR. By estimating the expected duration in each renal state and incorporating associated annual costs, disease severity at presentation can be used to anticipate future health care costs. This is critical knowledge for cost-effectiveness evaluations of novel therapies.

Published
2018

195. Phase II Randomized Trial of Rituximab Plus Cyclophosphamide Followed by Belimumab for the Treatment of Lupus Nephritis.

Author

Atisha‐Fregoso, Yemil, Malkiel, Susan, Harris, Kristina M., Byron, Margie, Ding, Linna, Kanaparthi, Sai, Barry, William T., Gao, Wendy, Ryker, Kristin, Tosta, Patti, Askanase, Anca D., Boackle, Susan A., Chatham, W. Winn, Kamen, Diane L., Karp, David R., Kirou, Kyriakos A., Sam Lim, S., Marder, Bradley, McMahon, Maureen, and Parikh, Samir V.

Subjects
LUPUS nephritis, RITUXIMAB, RANDOMIZED controlled trials, TREATMENT effectiveness, CYCLOPHOSPHAMIDE, DATA analysis software, DESCRIPTIVE statistics, BELIMUMAB
Abstract

Objective: To assess the safety, mechanism of action, and preliminary efficacy of rituximab followed by belimumab in the treatment of refractory lupus nephritis (LN). Methods: In a multicenter, randomized, open‐label clinical trial, 43 patients with recurrent or refractory LN were treated with rituximab, cyclophosphamide (CYC), and glucocorticoids followed by weekly belimumab infusions until week 48 (RCB group), or treated with rituximab and CYC but no belimumab infusions (RC group). Patients were followed up until week 96. Percentages of total and autoreactive B cell subsets in the patients' peripheral blood were analyzed by flow cytometry. Results: Treatment with belimumab did not increase the incidence of adverse events in patients with refractory LN. At week 48, a complete or partial renal response occurred in 11 (52%) of 21 patients receiving belimumab, compared to 9 (41%) of 22 patients in the RC group who did not receive belimumab (P = 0.452). Lack of improvement in or worsening of LN was the major reason for treatment failure. B cell depletion occurred in both groups, but the percentage of B cells remained lower in those receiving belimumab (geometric mean number of B cells at week 60, 53 cells/μl in the RCB group versus 11 cells/μl in the RC group; P = 0.0012). Percentages of total and autoreactive transitional B cells increased from baseline to week 48 in both groups. However, percentages of total and autoreactive naive B cells decreased from baseline to week 48 in the belimumab group compared to the no belimumab RC group (P = 0.0349), a finding that is consistent with the observed impaired maturation of naive B cells and enhanced censoring of autoreactive B cells. Conclusion: The addition of belimumab to a treatment regimen with rituximab and CYC was safe in patients with refractory LN. This regimen diminished maturation of transitional to naive B cells during B cell reconstitution, and enhanced the negative selection of autoreactive B cells. Clinical efficacy was not improved with rituximab and CYC in combination with belimumab when compared to a therapeutic strategy of B cell depletion alone in patients with LN. [ABSTRACT FROM AUTHOR]

Published
2021
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196. Transancestral mapping and genetic load in systemic lupus erythematosus

Author

Langefeld, Carl D, Ainsworth, Hannah C, Cunninghame Graham, Deborah S, Kelly, Jennifer A, Comeau, Mary E, Marion, Miranda C, Howard, Timothy D, Ramos, Paula S, Croker, Jennifer A, Morris, David L, Sandling, Johanna K, Almlöf, Jonas Carlsson, Acevedo-Vásquez, Eduardo M, Alarcón, Graciela S, Babini, Alejandra M, Baca, Vicente, Bengtsson, Anders A, Berbotto, Guillermo A, Bijl, Marc, Brown, Elizabeth E, Brunner, Hermine I, Cardiel, Mario H, Catoggio, Luis, Cervera, Ricard, Cucho-Venegas, Jorge M, Dahlqvist, Solbritt Rantapää, D'Alfonso, Sandra, Da Silva, Berta Martins, de la Rúa Figueroa, Iñigo, Doria, Andrea, Edberg, Jeffrey C, Endreffy, Emőke, Esquivel-Valerio, Jorge A, Fortin, Paul R, Freedman, Barry I, Frostegård, Johan, García, Mercedes A, de la Torre, Ignacio García, Gilkeson, Gary S, Gladman, Dafna D, Gunnarsson, Iva, Guthridge, Joel M, Huggins, Jennifer L, James, Judith A, Kallenberg, Cees GM, Kamen, Diane L, Karp, David R, Kaufman, Kenneth M, Kottyan, Leah C, Kovács, László, Laustrup, Helle, Lauwerys, Bernard R, Li, Quan-Zhen, Maradiaga-Ceceña, Marco A, Martín, Javier, McCune, Joseph M, McWilliams, David R, Merrill, Joan T, Miranda, Pedro, Moctezuma, José F, Nath, Swapan K, Niewold, Timothy B, Orozco, Lorena, Ortego-Centeno, Norberto, Petri, Michelle, Pineau, Christian A, Pons-Estel, Bernardo A, Pope, Janet, Raj, Prithvi, Ramsey-Goldman, Rosalind, Reveille, John D, Russell, Laurie P, Sabio, José M, Aguilar-Salinas, Carlos A, Scherbarth, Hugo R, Scorza, Raffaella, Seldin, Michael F, Sjöwall, Christopher, Svenungsson, Elisabet, Thompson, Susan D, Toloza, Sergio MA, Truedsson, Lennart, Tusié-Luna, Teresa, Vasconcelos, Carlos, Vilá, Luis M, Wallace, Daniel J, Weisman, Michael H, Wither, Joan E, Bhangale, Tushar, Oksenberg, Jorge R, Rioux, John D, Gregersen, Peter K, Syvänen, Ann-Christine, Rönnblom, Lars, Criswell, Lindsey A, Jacob, Chaim O, Sivils, Kathy L, Tsao, Betty P, Schanberg, Laura E, and Behrens, Timothy W

Subjects
Multifactorial Inheritance, American Native Continental Ancestry Group, European Continental Ancestry Group, Black People, Lupus, Autoimmune Disease, White People, Clinical Research, immune system diseases, HLA Antigens, Insertional, Genetics, 2.1 Biological and endogenous factors, Humans, Aetiology, Age of Onset, Polymorphism, skin and connective tissue diseases, American Indian or Alaska Native, Sequence Deletion, African Continental Ancestry Group, Lupus Erythematosus, Whites, Inflammatory and immune system, Systemic, Hispanic or Latino, Single Nucleotide, Blacks, Logistic Models, Mutagenesis, Case-Control Studies, Genetic Load, Hispanic Americans
Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease with marked gender and ethnic disparities. We report a large transancestral association study of SLE using Immunochip genotype data from 27,574 individuals of European (EA), African (AA) and Hispanic Amerindian (HA) ancestry. We identify 58 distinct non-HLA regions in EA, 9 in AA and 16 in HA (∼50% of these regions have multiple independent associations); these include 24 novel SLE regions (P

Published
2017

197. Examining Racial Differences in Access to Primary Care for People Living with Lupus: Use of Ambulatory Care Sensitive Conditions to Measure Access.

Author

Brown, Elizabeth A., Gebregziabher, Mulugeta, Kamen, Diane L., White, Brandi M., and Williams, Edith M.

Subjects
PRIMARY care, OUTPATIENT medical care, COMMUNITY health workers, RACIAL differences, HEALTH insurance, ODDS ratio, MEDICAL quality control, STATISTICS on minorities, SYSTEMIC lupus erythematosus treatment, MEDICAID statistics, RESEARCH, HEALTH services accessibility, CROSS-sectional method, RESEARCH methodology, MEDICAL cooperation, EVALUATION research, PRIMARY health care, COMPARATIVE studies, HOSPITAL care, RESEARCH funding, MEDICARE
Abstract

Background: People living with lupus may experience poor access to primary care and delayed specialty care.Purpose: To identify characteristics that lead to increased odds of poor access to primary care for minorities hospitalized with lupus.Methods: Cross-sectional design with 2011-2012 hospitalization data from South Carolina, North Carolina, and Florida. We used ICD-9 codes to identify lupus hospitalizations. Ambulatory care sensitive conditions were used to identify preventable lupus hospitalizations and measure access to primary care. Logistic regression was used to estimate the odds ratio for the association between predictors and having poor access to primary care. Sensitivity analysis excluded patients aged >65 years.Results: There were 23,154 total lupus hospitalizations, and 2,094 (9.04%) were preventable. An adjusted model showed minorities aged ≥65 years (OR 2.501, CI 1.501, 4.169), minorities aged 40-64 years (OR 2.248, CI: 1.394, 3.627), minorities with Medicare insurance (OR 1.669, CI:1.353,2.059) and minorities with Medicaid (OR 1.662,CI:1.321, 2.092) had the highest odds for a preventable lupus hospitalization. Minorities with Medicare had significantly higher odds for ≥3 hospital days (OR 1.275, CI: 1.149, 1.415). Whites with Medicare (OR 1.291, CI: 1.164, 1.432) had the highest odds for ≥3 days.Conclusions: Our data show that middle-aged minorities living with lupus and on public health insurance have a higher likelihood of poor access to primary care. Health care workers and policymakers should develop plans to identify patients, explore issues affecting access, and place patients with a community health worker or social worker to promote better access to primary care. [ABSTRACT FROM AUTHOR]

Published
2020
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198. Economic Evaluation of Lupus Nephritis in the Systemic Lupus International Collaborating Clinics Inception Cohort Using a Multistate Model Approach

Author

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

Published
2018
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199. CS-07 Economic evaluation of damage accrual in an international SLE inception cohort

Author

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

Published
2018
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