484 results on '"Lim, S Sam"'
Search Results
2. Remote Administration of Physical and Cognitive Performance Assessments in a Predominantly Black Cohort of Persons With Systemic Lupus Erythematosus
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Hoge, Courtney, Bowling, C Barrett, Dunlop‐Thomas, Charmayne, Pearce, Brad D, Drenkard, Cristina, Lim, S Sam, and Plantinga, Laura C
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Biomedical and Clinical Sciences ,Clinical Sciences ,Lupus ,Pediatric Research Initiative ,Clinical Research ,Behavioral and Social Science ,Clinical sciences - Abstract
ObjectiveIn a study of physical and cognitive functioning among predominantly Black individuals with systemic lupus erythematosus (SLE), we compared remotely administered physical and cognitive performance assessments to those collected in person.MethodsA subset of participants who completed an in-person visit in our parent study from 2021 to 2022 (n = 30) were recruited to complete a second, remote visit within 28 days. Physical performance (measured by a modified Short Physical Performance Battery [SPPB]; range 0-12; subscale ranges 0-4; higher = better performance) and cognitive performance (episodic and working memory adjusted t-scores, measured using NIH Toolbox) were measured at both visits. Mean scores were compared using paired t-tests; intraclass correlation coefficients (ICCs) were obtained from two-way mixed effects models. Linear and logistic models were used to estimate stratified associations between performance measures and related outcomes.ResultsParticipants were primarily female (93.3%) and Black (93.3%). In-person versus remote overall SPPB (8.76 vs. 9.43) and chair stand (1.43 vs. 1.90) scores were statistically significantly lower. t-Scores for episodic memory (47.27 vs. 49.53) and working memory (45.37 vs. 47.90) were lower for in-person versus remote visits. The ICC for overall SPPB indicated good agreement (0.76), whereas the ICCs for episodic (0.49) and working memory (0.57) indicated poor-moderate agreement. Associations between assessments of performance with related outcomes were similar and did not statistically significantly differ by modality of visit.ConclusionTo possibly expand and diversify pools of participants in studies of physical and cognitive performance in SLE, remote administration of assessments should be considered for future research.
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- 2023
3. Predictors of British Isles Lupus Assessment Group-based outcomes in patients with systemic lupus erythematosus: Analysis from the Systemic Lupus International Collaborating Clinics Inception Cohort
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David, Trixy, Su, Li, Cheng, Yafeng, Gordon, Caroline, Parker, Benjamin, Isenberg, David, Reynolds, John A, Bruce, Ian N, Hanly, John G, Bae, Sang-Cheol, Romero-Diaz, Juanita, Sanchez-Guerrero, Jorge, Bernatsky, Sasha, Clarke, Ann E, Wallace, Daniel J, Rahman, Anisur, Merrill, Joan T, Fortin, Paul R, Gladman, Dafna D, Urowitz, Murray B, Petri, Michelle, Ginzler, Ellen M, Dooley, MA, Ramsey-Goldman, Rosalind, Manzi, Susan, Jonsen, Andreas, Alarcón, Graciela S, van Vollenhoven, Ronald F, Aranow, Cynthia, Mackay, Meggan, Ruiz-Irastorza, Guillermo, Lim, S Sam, Inanc, Murat, Kalunian, Kenneth C, Jacobsen, Soren, Peschken, Christine A, Kamen, Diane L, Askanase, Anca, Payne, Katherine, Lunt, Mark, Peek, Niels, Geifman, Nophar, Gavan, Sean, Armitt, Gillian, Doherty, Patrick, Prattley, Jennifer, Azadbakht, Narges, Papazian, Angela, Le Sueur, Helen, Farrelly, Carmen, Richardson, Clare, Shabbir, Zunnaira, Hewitt, Lauren, McHugh, Neil, Reynolds, John, Young, Stephen, Jayne, David, Farewell, Vern, Pickering, Matthew, Lightstone, Elizabeth, Gilmore, Alyssa, Botto, Marina, Vyse, Timothy, Morris, David Lester, D’Cruz, D, Vital, Edward, Wittmann, Miriam, Emery, Paul, Beresford, Michael, Hedrich, Christian, Midgley, Angela, Gritzfeld, Jenna, Ehrenstein, Michael, Parvaz, Mariea, Dunnage, Jane, Batchelor, Jane, Holland, E, and Upsall, Pauline
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Biomedical and Clinical Sciences ,Clinical Sciences ,Autoimmune Disease ,Lupus ,Clinical Research ,Humans ,Lupus Erythematosus ,Systemic ,Immunosuppressive Agents ,Outcome Assessment ,Health Care ,Logistic Models ,United Kingdom ,Severity of Illness Index ,International Collaborating Clinics Consortium ,MASTERPLANS Consortium ,Systemic lupus erythematosus ,clinical outcomes ,disease activity ,predictors ,Arthritis & Rheumatology ,Clinical sciences - Abstract
BackgroundWe aimed to identify factors associated with a significant reduction in SLE disease activity over 12 months assessed by the BILAG Index.MethodsIn an international SLE cohort, we studied patients from their 'inception enrolment' visit. We also defined an 'active disease' cohort of patients who had active disease similar to that needed for enrolment into clinical trials. Outcomes at 12 months were; Major Clinical Response (MCR: reduction to classic BILAG C in all domains, steroid dose of ≤7.5 mg and SLEDAI ≤ 4) and 'Improvement' (reduction to ≤1B score in previously active organs; no new BILAG A/B; stable or reduced steroid dose; no increase in SLEDAI). Univariate and multivariate logistic regression with Least Absolute Shrinkage and Selection Operator (LASSO) and cross-validation in randomly split samples were used to build prediction models.Results'Inception enrolment' (n = 1492) and 'active disease' (n = 924) patients were studied. Models for MCR performed well (ROC AUC = .777 and .732 in the inception enrolment and active disease cohorts, respectively). Models for Improvement performed poorly (ROC AUC = .574 in the active disease cohort). MCR in both cohorts was associated with anti-malarial use and inversely associated with active disease at baseline (BILAG or SLEDAI) scores, BILAG haematological A/B scores, higher steroid dose and immunosuppressive use.ConclusionBaseline predictors of response in SLE can help identify patients in clinic who are less likely to respond to standard therapy. They are also important as stratification factors when designing clinical trials in order to better standardize overall usual care response rates.
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- 2023
4. Retinal toxicity in a multinational inception cohort of patients with systemic lupus on hydroxychloroquine
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Almeida-Brasil, Celline C, Hanly, John G, Urowitz, Murray, Clarke, Ann Elaine, Ruiz-Irastorza, Guillermo, Gordon, Caroline, Ramsey-Goldman, Rosalind, Petri, Michelle A, Ginzler, Ellen M, Wallace, Daniel J, Bae, Sang-Cheol, Romero-Diaz, Juanita, Dooley, Mary-Anne, Peschken, Christine, Isenberg, David, Rahman, Anisur, Manzi, Susan, Jacobsen, Søren, Lim, S Sam, van Vollenhoven, Ronald, Nived, Ola, Jönsen, Andreas, Kamen, Diane L, Aranow, Cynthia, Sánchez-Guerrero, Jorge, Gladman, Dafna D, Fortin, Paul R, Alarcon, Graciela S, Merrill, Joan T, Kalunian, Kenneth, Ramos-Casals, Manuel, Steinsson, Kristjan, Zoma, A, Askanase, Anca D, Khamashta, Munther, Bruce, Ian N, Inanc, Murat, Lukusa, Luck, and Bernatsky, Sasha
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Biomedical and Clinical Sciences ,Ophthalmology and Optometry ,Aging ,Prevention ,Autoimmune Disease ,Lupus ,Clinical Research ,Eye Disease and Disorders of Vision ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Eye ,Good Health and Well Being ,Humans ,Female ,Aged ,Male ,Hydroxychloroquine ,Antirheumatic Agents ,Lupus Erythematosus ,Systemic ,Retinal Diseases ,Chloroquine ,epidemiology ,lupus erythematosus ,systemic ,outcome assessment ,health care ,lupus erythematosus ,systemic ,outcome assessment ,health care ,Clinical sciences ,Immunology - Abstract
ObjectiveTo evaluate hydroxychloroquine (HCQ)-related retinal toxicity in the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort.MethodsData were collected at annual study visits between 1999 and 2019. We followed patients with incident SLE from first visit on HCQ (time zero) up to time of retinal toxicity (outcome), death, loss-to-follow-up or end of study. Potential retinal toxicity was identified from SLICC Damage Index scores; cases were confirmed with chart review. Using cumulative HCQ duration as the time axis, we constructed univariate Cox regression models to assess if covariates (ie, HCQ daily dose/kg, sex, race/ethnicity, age at SLE onset, education, body mass index, renal damage, chloroquine use) were associated with HCQ-related retinal toxicity.ResultsWe studied 1460 patients (89% female, 52% white). Retinal toxicity was confirmed in 11 patients (incidence 1.0 per 1000 person-years, 0.8% overall). Average cumulative time on HCQ in those with retinal toxicity was 7.4 (SD 3.2) years; the first case was detected 4 years after HCQ initiation. Risk of retinal toxicity was numerically higher in older patients at SLE diagnosis (univariate HR 1.05, 95% CI 1.01 to 1.09).ConclusionsThis is the first assessment of HCQ and retinal disease in incident SLE. We did not see any cases of retinopathy within the first 4 years of HCQ. Cumulative HCQ may be associated with increased risk. Ophthalmology monitoring (and formal assessment of cases of potential toxicity, by a retinal specialist) remains important, especially in patients on HCQ for 10+ years, those needing higher doses and those of older age at SLE diagnosis.
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- 2022
5. Financial Hardship and Sleep Quality Among Black American Women With and Without Systemic Lupus Erythematosus
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Abdallah, Khadijah, Udaipuria, Shivika, Murden, Raphiel, McKinnon, Izraelle I., Erving, Christy L., Fields, Nicole, Moore, Reneé, Booker, Bianca, Burey, Taylor, Dunlop-Thomas, Charmayne, Drenkard, Cristina, Johnson, Dayna A., Vaccarino, Viola, Lim, S. Sam, and Lewis, Tené T.
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- 2024
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6. Prediction of Hospitalizations in Systemic Lupus Erythematosus Using the Systemic Lupus International Collaborating Clinics Frailty Index
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Legge, Alexandra, Kirkland, Susan, Rockwood, Kenneth, Andreou, Pantelis, Bae, Sang‐Cheol, Gordon, Caroline, Romero‐Diaz, Juanita, Sanchez‐Guerrero, Jorge, Wallace, Daniel J, Bernatsky, Sasha, Clarke, Ann E, Merrill, Joan T, Ginzler, Ellen M, Fortin, Paul R, Gladman, Dafna D, Urowitz, Murray B, Bruce, Ian N, Isenberg, David A, Rahman, Anisur, Alarcón, Graciela S, Petri, Michelle, Khamashta, Munther A, Dooley, MA, Ramsey‐Goldman, Rosalind, Manzi, Susan, Zoma, Asad A, Aranow, Cynthia, Mackay, Meggan, Ruiz‐Irastorza, Guillermo, Lim, S Sam, Inanc, Murat, Vollenhoven, Ronald F, Jonsen, Andreas, Nived, Ola, Ramos‐Casals, Manuel, Kamen, Diane L, Kalunian, Kenneth C, Jacobsen, Søren, Peschken, Christine A, Askanase, Anca, and Hanly, John G
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Epidemiology ,Biomedical and Clinical Sciences ,Health Sciences ,Lupus ,Clinical Research ,Autoimmune Disease ,Inflammatory and immune system ,Good Health and Well Being ,Adult ,Female ,Frailty ,Hospitalization ,Humans ,Immunosuppressive Agents ,Lupus Erythematosus ,Systemic ,Male ,Middle Aged ,Severity of Illness Index ,Young Adult ,Clinical Sciences ,Public Health and Health Services ,Psychology ,Clinical sciences ,Allied health and rehabilitation science - Abstract
ObjectiveThe Systemic Lupus International Collaborating Clinics (SLICC) frailty index (FI) predicts mortality and damage accrual in systemic lupus erythematosus (SLE), but its association with hospitalizations has not been described. Our objective was to estimate the association of baseline SLICC-FI values with future hospitalizations in the SLICC inception cohort.MethodsBaseline SLICC-FI scores were calculated. The number and duration of inpatient hospitalizations during follow-up were recorded. Negative binomial regression was used to estimate the association between baseline SLICC-FI values and the rate of hospitalizations per patient-year of follow-up. Linear regression was used to estimate the association of baseline SLICC-FI scores with the proportion of follow-up time spent in the hospital. Multivariable models were adjusted for relevant baseline characteristics.ResultsThe 1,549 patients with SLE eligible for this analysis were mostly female (88.7%), with a mean ± SD age of 35.7 ± 13.3 years and a median disease duration of 1.2 years (interquartile range 0.9-1.5) at baseline. Mean ± SD baseline SLICC-FI was 0.17 ± 0.08. During mean ± SD follow-up of 7.2 ± 3.7 years, 614 patients (39.6%) experienced 1,570 hospitalizations. Higher baseline SLICC-FI values (per 0.05 increment) were associated with more frequent hospitalizations during follow-up, with an incidence rate ratio of 1.21 (95% confidence interval [95% CI] 1.13-1.30) after adjustment for baseline age, sex, glucocorticoid use, immunosuppressive use, ethnicity/location, SLE Disease Activity Index 2000 score, SLICC/American College of Rheumatology Damage Index score, and disease duration. Among patients with ≥1 hospitalization, higher baseline SLICC-FI values predicted a greater proportion of follow-up time spent hospitalized (relative rate 1.09 [95% CI 1.02-1.16]).ConclusionThe SLICC-FI predicts future hospitalizations among incident SLE patients, further supporting the SLICC-FI as a valid health measure in SLE.
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- 2022
7. Mycophenolate mofetil withdrawal in patients with systemic lupus erythematosus: a multicentre, open-label, randomised controlled trial
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Chakravarty, Eliza F, Utset, Tammy, Kamen, Diane L, Contreras, Gabriel, McCune, W Joseph, Aranow, Cynthia, Kalunian, Kenneth, Massarotti, Elena, Clowse, Megan E B, Rovin, Brad H, Lim, S Sam, Majithia, Vikas, Dall'Era, Maria, Looney, R John, Erkan, Doruk, Saxena, Amit, Olsen, Nancy J, Ko, Kichul, Guthridge, Joel M, Goldmuntz, Ellen, Springer, Jessica, D'Aveta, Carla, Keyes-Elstein, Lynette, Barry, Bill, Pinckney, Ashley, McNamara, James, and James, Judith A
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- 2024
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8. Neuropsychiatric Events in Systemic Lupus Erythematosus: Predictors of Occurrence and Resolution in a Longitudinal Analysis of an International Inception Cohort
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Hanly, John G, 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, Urowitz, Murray B, Bruce, Ian N, Petri, Michelle, Ginzler, Ellen M, Dooley, MA, Ramsey‐Goldman, Rosalind, Manzi, Susan, Jonsen, Andreas, Alarcón, Graciela S, Vollenhoven, Ronald F, Aranow, Cynthia, Mackay, Meggan, Ruiz‐Irastorza, Guillermo, Lim, S Sam, Inanc, Murat, Kalunian, Kenneth C, Jacobsen, Soren, Peschken, Christine A, Kamen, Diane L, Askanase, Anca, and Farewell, Vernon
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Biomedical and Clinical Sciences ,Clinical Sciences ,Autoimmune Disease ,Clinical Research ,Lupus ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Inflammatory and immune system ,Adult ,Female ,Headache ,Humans ,Longitudinal Studies ,Lupus Erythematosus ,Systemic ,Male ,Middle Aged ,Models ,Theoretical ,Prospective Studies ,Quality of Life ,Sex Factors ,Young Adult ,Immunology ,Public Health and Health Services ,Arthritis & Rheumatology ,Clinical sciences - Abstract
ObjectiveTo determine predictors of change in neuropsychiatric (NP) event status in a large, prospective, international inception cohort of patients with systemic lupus erythematosus (SLE).MethodsUpon enrollment and annually thereafter, NP events attributed to SLE and non-SLE causes and physician-determined resolution were documented. Factors potentially associated with the onset and resolution of NP events were determined by time-to-event analysis using a multistate modeling structure.ResultsNP events occurred in 955 (52.3%) of 1,827 patients, and 593 (31.0%) of 1,910 unique events were attributed to SLE. For SLE-associated NP (SLE NP) events, multivariate analysis revealed a positive association with male sex (P = 0.028), concurrent non-SLE NP events excluding headache (P < 0.001), active SLE (P = 0.012), and glucocorticoid use (P = 0.008). There was a negative association with Asian race (P = 0.002), postsecondary education (P = 0.001), and treatment with immunosuppressive drugs (P = 0.019) or antimalarial drugs (P = 0.056). For non-SLE NP events excluding headache, there was a positive association with concurrent SLE NP events (P < 0.001) and a negative association with African race (P = 0.012) and Asian race (P < 0.001). NP events attributed to SLE had a higher resolution rate than non-SLE NP events, with the exception of headache, which had comparable resolution rates. For SLE NP events, multivariate analysis revealed that resolution was more common in patients of Asian race (P = 0.006) and for central/focal NP events (P < 0.001). For non-SLE NP events, resolution was more common in patients of African race (P = 0.017) and less common in patients who were older at SLE diagnosis (P < 0.001).ConclusionIn a large and long-term study of the occurrence and resolution of NP events in SLE, we identified subgroups with better and worse prognosis. The course of NP events differs greatly depending on their nature and attribution.
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- 2021
9. Cancer Risk in a Large Inception Systemic Lupus Erythematosus Cohort: Effects of Demographic Characteristics, Smoking, and Medications
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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
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Health Services and Systems ,Biomedical and Clinical Sciences ,Health Sciences ,Oncology and Carcinogenesis ,Clinical Research ,Autoimmune Disease ,Prevention ,Lung ,Patient Safety ,Lung Cancer ,Lupus ,Rare Diseases ,Cancer ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Good Health and Well Being ,Adult ,Antimalarials ,Female ,Humans ,Immunosuppressive Agents ,Lupus Erythematosus ,Systemic ,Male ,Middle Aged ,Neoplasms ,Risk Factors ,Smoking ,Clinical Sciences ,Public Health and Health Services ,Psychology ,Clinical sciences ,Allied health and rehabilitation science - Abstract
ObjectiveTo assess cancer risk factors in incident systemic lupus erythematosus (SLE).MethodsClinical 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.ResultsAmong 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.ConclusionSmoking 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.
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- 2021
10. Physical Performance in a Diverse, Population‐Based Cohort of Individuals With Systemic Lupus Erythematosus
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Plantinga, Laura C., Bowling, C. Barrett, Hoge, Courtney, Dunlop‐Thomas, Charmayne, Pearce, Bradley D., Lim, S. Sam, and Drenkard, Cristina
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- 2024
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11. Lower vitamin D is associated with metabolic syndrome and insulin resistance in systemic lupus: data from an international inception cohort.
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Chew, Christine, Reynolds, John A, Lertratanakul, Apinya, Wu, Peggy, Urowitz, Murray, Gladman, Dafna D, Fortin, Paul R, Bae, Sang-Cheol, Gordon, Caroline, Clarke, Ann E, Bernatsky, Sasha, Hanly, John G, Isenberg, David, Rahman, Anisur, Sanchez-Guerrero, Jorge, Romero-Diaz, Juanita, Merrill, Joan, Wallace, Daniel, Ginzler, Ellen, Khamashta, Munther, Nived, Ola, Jönsen, Andreas, Steinsson, Kristjan, Manzi, Susan, Kalunian, Ken, Dooley, Mary Anne, Petri, Michelle, Aranow, Cynthia, van Vollenhoven, Ronald, Stoll, Thomas, Alarcón, Graciela S, Lim, S Sam, Ruiz-Irastorza, Guillermo, Peschken, Christine A, Askanase, Anca D, Kamen, Diane L, İnanç, Murat, Ramsey-Goldman, Rosalind, and Bruce, Ian N
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Cardiovascular ,Diabetes ,Clinical Research ,Autoimmune Disease ,Lupus ,Nutrition ,Metabolic and endocrine ,Adult ,Cohort Studies ,Cross-Sectional Studies ,Female ,Global Health ,Humans ,Insulin Resistance ,Lupus Erythematosus ,Systemic ,Male ,Metabolic Syndrome ,Vitamin D ,Vitamin D Deficiency ,Young Adult ,systemic lupus erythematosus ,vitamin D ,cardiovascular disease ,epidemiology ,Clinical Sciences ,Immunology ,Public Health and Health Services ,Arthritis & Rheumatology - Abstract
ObjectivesVitamin D (25(OH)D) deficiency and metabolic syndrome (MetS) may both contribute to increased cardiovascular risk in SLE. We aimed to examine the association of demographic factors, SLE phenotype, therapy and vitamin D levels with MetS and insulin resistance.MethodsThe Systemic Lupus International Collaborating Clinics (SLICC) enrolled patients recently diagnosed with SLE (
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- 2021
12. Introduction to the Special Theme Issue: COVID‐19 & Rheumatology: Emerging Insights and Impacts
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Brady, Teresa J., Lim, S. Sam, and Allen, Kelli D.
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- 2024
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13. Prediction of Damage Accrual in Systemic Lupus Erythematosus Using the Systemic Lupus International Collaborating Clinics Frailty Index
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Legge, Alexandra, Kirkland, Susan, Rockwood, Kenneth, Andreou, Pantelis, Bae, Sang‐Cheol, Gordon, Caroline, Romero‐Diaz, Juanita, Sanchez‐Guerrero, Jorge, Wallace, Daniel J, Bernatsky, Sasha, Clarke, Ann E, Merrill, Joan T, Ginzler, Ellen M, Fortin, Paul R, Gladman, Dafna D, Urowitz, Murray B, Bruce, Ian N, Isenberg, David A, Rahman, Anisur, Alarcón, Graciela S, Petri, Michelle, Khamashta, Munther A, Dooley, MA, Ramsey‐Goldman, Rosalind, Manzi, Susan, Zoma, Asad A, Aranow, Cynthia, Mackay, Meggan, Ruiz‐Irastorza, Guillermo, Lim, S Sam, Inanc, Murat, Vollenhoven, Ronald F, Jonsen, Andreas, Nived, Ola, Ramos‐Casals, Manuel, Kamen, Diane L, Kalunian, Kenneth C, Jacobsen, Soren, Peschken, Christine A, Askanase, Anca, and Hanly, John G
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Autoimmune Disease ,Lupus ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Inflammatory and immune system ,Good Health and Well Being ,Adult ,Disease Progression ,Female ,Frailty ,Humans ,Immunosuppressive Agents ,Lupus Erythematosus ,Systemic ,Male ,Middle Aged ,Quality of Life ,Severity of Illness Index ,Young Adult ,Clinical Sciences ,Immunology ,Public Health and Health Services ,Arthritis & Rheumatology - Abstract
ObjectiveThe Systemic Lupus International Collaborating Clinics (SLICC) frailty index (FI) has been shown to predict mortality, but its association with other important outcomes is unknown. We examined the association of baseline SLICC FI values with damage accrual in the SLICC inception cohort.MethodsThe baseline visit was defined as the first visit at which both organ damage (SLICC/American College of Rheumatology Damage Index [SDI]) and health-related quality of life (Short Form 36) were assessed. Baseline SLICC FI scores were calculated. Damage accrual was measured by the increase in SDI between the baseline assessment and the last study visit. Multivariable negative binomial regression was used to estimate the association between baseline SLICC FI values and the rate of increase in the SDI during follow-up, adjusting for relevant demographic and clinical characteristics.ResultsThe 1,549 systemic lupus erythematosus (SLE) patients eligible for this analysis were mostly female (88.7%) with a mean ± SD age of 35.7 ± 13.3 years and a median disease duration of 1.2 years (interquartile range 0.9-1.5 years) at baseline. The mean ± SD baseline SLICC FI was 0.17 ± 0.08. Over a mean ± SD follow-up of 7.2 ± 3.7 years, 653 patients (42.2%) had an increase in SDI. Higher baseline SLICC FI values (per 0.05 increase) were associated with higher rates of increase in the SDI during follow-up (incidence rate ratio [IRR] 1.19 [95% confidence interval 1.13-1.25]), after adjusting for age, sex, ethnicity/region, education, baseline SLE Disease Activity Index 2000, baseline SDI, and baseline use of glucocorticoids, antimalarials, and immunosuppressive agents.ConclusionOur findings indicate that the SLICC FI predicts damage accrual in incident SLE, which further supports the SLICC FI as a valid health measure in SLE.
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- 2020
14. Peripheral Nervous System Disease in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study
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Hanly, John G, Li, Qiuju, Su, Li, Urowitz, Murray B, Gordon, Caroline, Bae, Sang‐Cheol, Romero‐Diaz, Juanita, Sanchez‐Guerrero, Jorge, Bernatsky, Sasha, Clarke, Ann E, Wallace, Daniel J, Isenberg, David A, Rahman, Anisur, Merrill, Joan T, Fortin, Paul R, Gladman, Dafna D, Bruce, Ian N, Petri, Michelle, Ginzler, Ellen M, Dooley, MA, Steinsson, Kristjan, Ramsey‐Goldman, Rosalind, Zoma, Asad A, Manzi, Susan, Nived, Ola, Jonsen, Andreas, Khamashta, Munther A, Alarcón, Graciela S, Svenungsson, Elisabet, 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
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Biomedical and Clinical Sciences ,Clinical Sciences ,Chronic Pain ,Neurosciences ,Pain Research ,Clinical Research ,Neurodegenerative ,Lupus ,Peripheral Neuropathy ,Autoimmune Disease ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Inflammatory and immune system ,Neurological ,Good Health and Well Being ,Adult ,Age Factors ,Cohort Studies ,Cranial Nerve Diseases ,Female ,Humans ,Lupus Erythematosus ,Systemic ,Lupus Vasculitis ,Central Nervous System ,Male ,Middle Aged ,Mononeuropathies ,Multivariate Analysis ,Peripheral Nervous System Diseases ,Proportional Hazards Models ,Severity of Illness Index ,Young Adult ,Immunology ,Public Health and Health Services ,Arthritis & Rheumatology ,Clinical sciences - Abstract
ObjectiveTo determine the frequency, clinical characteristics, associations, and outcomes of different types of peripheral nervous system (PNS) disease in a multiethnic/multiracial, prospective inception cohort of systemic lupus erythematosus (SLE) patients.MethodsPatients were evaluated annually for 19 neuropsychiatric (NP) events including 7 types of PNS disease. SLE disease activity, organ damage, autoantibodies, and patient and physician assessment of outcome were measured. Time to event and linear regressions were used as appropriate.ResultsOf 1,827 SLE patients, 88.8% were female, and 48.8% were white. The mean ± SD age was 35.1 ± 13.3 years, disease duration at enrollment was 5.6 ± 4.2 months, and follow-up was 7.6 ± 4.6 years. There were 161 PNS events in 139 (7.6%) of 1,827 patients. The predominant events were peripheral neuropathy (66 of 161 [41.0%]), mononeuropathy (44 of 161 [27.3%]), and cranial neuropathy (39 of 161 [24.2%]), and the majority were attributed to SLE. Multivariate Cox regressions suggested longer time to resolution in patients with a history of neuropathy, older age at SLE diagnosis, higher SLE Disease Activity Index 2000 scores, and for peripheral neuropathy versus other neuropathies. Neuropathy was associated with significantly lower Short Form 36 (SF-36) physical and mental component summary scores versus no NP events. According to physician assessment, the majority of neuropathies resolved or improved over time, which was associated with improvements in SF-36 summary scores for peripheral neuropathy and mononeuropathy.ConclusionPNS disease is an important component of total NPSLE and has a significant negative impact on health-related quality of life. The outcome is favorable for most patients, but our findings indicate that several factors are associated with longer time to resolution.
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- 2020
15. Construction of a Frailty Index as a Novel Health Measure in Systemic Lupus Erythematosus
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Legge, Alexandra, Kirkland, Susan, Rockwood, Kenneth, Andreou, Pantelis, Bae, Sang-Cheol, Gordon, Caroline, Romero-Diaz, Juanita, Sanchez-Guerrero, Jorge, Wallace, Daniel J, Bernatsky, Sasha, Clarke, Ann E, Merrill, Joan T, Ginzler, Ellen M, Fortin, Paul, Gladman, Dafna D, Urowitz, Murray B, Bruce, Ian N, Isenberg, David A, Rahman, Anisur, Alarcón, Graciela S, Petri, Michelle, Khamashta, Munther A, Dooley, MA, Ramsey-Goldman, Rosalind, Manzi, Susan, Zoma, Asad A, Aranow, Cynthia, Mackay, Meggan, Ruiz-Irastorza, Guillermo, Lim, S Sam, Inanc, Murat, van Vollenhoven, Ronald F, Jonsen, Andreas, Nived, Ola, Ramos-Casals, Manuel, Kamen, Diane L, Kalunian, Kenneth C, Jacobsen, Soren, Peschken, Christine A, Askanase, Anca, and Hanly, John G
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Autoimmune Disease ,Lupus ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Inflammatory and immune system ,Adult ,Female ,Frailty ,Humans ,Longitudinal Studies ,Lupus Erythematosus ,Systemic ,Male ,Middle Aged ,Patient Outcome Assessment ,Prevalence ,Severity of Illness Index ,Young Adult ,SYSTEMIC LUPUS ERYTHEMATOSUS ,OUTCOME ASSESSMENT ,COHORT STUDIES ,Immunology ,Public Health and Health Services ,Arthritis & Rheumatology ,Clinical sciences - Abstract
ObjectiveTo construct a Frailty Index (FI) as a measure of vulnerability to adverse outcomes among patients with systemic lupus erythematosus (SLE), using data from the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort.MethodsThe SLICC inception cohort consists of recently diagnosed patients with SLE followed annually with clinical and laboratory assessments. For this analysis, the baseline visit was defined as the first study visit at which sufficient information was available for construction of an FI. Following a standard procedure, variables from the SLICC database were evaluated as potential health deficits. Selected health deficits were then used to generate a SLICC-FI. The prevalence of frailty in the baseline dataset was evaluated using established cutpoints for FI values.ResultsThe 1683 patients with SLE (92.1% of the overall cohort) eligible for inclusion in the baseline dataset were mostly female (89%) with mean (SD) age 35.7 (13.4) years and mean (SD) disease duration 18.8 (15.7) months at baseline. Of 222 variables, 48 met criteria for inclusion in the SLICC-FI. Mean (SD) SLICC-FI was 0.17 (0.08) with a range from 0 to 0.51. At baseline, 27.1% (95% CI 25.0-29.2) of patients were classified as frail, based on SLICC-FI values > 0.21.ConclusionThe SLICC inception cohort permits feasible construction of an FI for use in patients with SLE. Even in a relatively young cohort of patients with SLE, frailty was common. The SLICC-FI may be a useful tool for identifying patients with SLE who are most vulnerable to adverse outcomes, but validation of this index is required prior to its use.
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- 2020
16. The Epidemiology of Systemic Lupus Erythematosus
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Lim, S. Sam, Lockshin, Michael D., editor, Crow, Mary K., editor, and Barbhaiya, Medha, editor
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- 2022
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17. Assessing the Costs of Neuropsychiatric Disease in the Systemic Lupus International Collaborating Clinics Cohort Using Multistate Modeling
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Clarke, Ann E., Hanly, John G., Urowitz, Murray B., St. Pierre, Yvan, Gordon, Caroline, Bae, Sang‐Cheol, Romero‐Diaz, Juanita, Sanchez‐Guerrero, Jorge, Bernatsky, Sasha, 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, Mary Anne, Ramsey‐Goldman, Rosalind, Manzi, Susan, Jönsen, Andreas, Alarcón, Graciela S., Van Vollenhoven, Ronald F., Aranow, Cynthia, Mackay, Meggan, Ruiz‐Irastorza, Guillermo, Lim, S. Sam, Inanc, Murat, Kalunian, Kenneth C., Jacobsen, Soren, Peschken, Christine A., Kamen, Diane L., Askanase, Anca, and Farewell, Vernon
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- 2023
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18. Fluid Cognition Among Individuals With Systemic Lupus Erythematosus
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Plantinga, Laura C., primary, Yazdany, Jinoos, additional, Pearce, Bradley D., additional, Hoge, Courtney, additional, Dunlop‐Thomas, Charmayne, additional, Lim, S. Sam, additional, Drenkard, Cristina, additional, Katz, Patricia P., additional, and Bowling, C. Barrett, additional
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- 2024
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19. Evaluating the Properties of a Frailty Index and Its Association With Mortality Risk Among Patients With Systemic Lupus Erythematosus
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Legge, Alexandra, Kirkland, Susan, Rockwood, Kenneth, Andreou, Pantelis, Bae, Sang‐Cheol, Gordon, Caroline, Romero‐Diaz, Juanita, Sanchez‐Guerrero, Jorge, Wallace, Daniel J, Bernatsky, Sasha, Clarke, Ann E, Merrill, Joan T, Ginzler, Ellen M, Fortin, Paul, Gladman, Dafna D, Urowitz, Murray B, Bruce, Ian N, Isenberg, David A, Rahman, Anisur, Alarcón, Graciela S, Petri, Michelle, Khamashta, Munther A, Dooley, MA, Ramsey‐Goldman, Rosalind, Manzi, Susan, Steinsson, Kristjan, Zoma, Asad A, Aranow, Cynthia, Mackay, Meggan, Ruiz‐Irastorza, Guillermo, Lim, S Sam, Inanc, Murat, Vollenhoven, Ronald F, Jonsen, Andreas, Nived, Ola, Ramos‐Casals, Manuel, Kamen, Diane L, Kalunian, Kenneth C, Jacobsen, Soren, Peschken, Christine A, Askanase, Anca, and Hanly, John G
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Biomedical and Clinical Sciences ,Clinical Sciences ,Immunology ,Autoimmune Disease ,Behavioral and Social Science ,Lupus ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Inflammatory and immune system ,Good Health and Well Being ,Adult ,Aged ,Female ,Frailty ,Humans ,Lupus Erythematosus ,Systemic ,Male ,Middle Aged ,Proportional Hazards Models ,Quality of Life ,Reproducibility of Results ,Risk Assessment ,Risk Factors ,Severity of Illness Index ,Public Health and Health Services ,Arthritis & Rheumatology ,Clinical sciences - Abstract
ObjectiveTo evaluate the properties of a frailty index (FI), constructed using data from the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort, as a novel health measure in systemic lupus erythematosus (SLE).MethodsFor this secondary analysis, the baseline visit was defined as the first study visit at which both organ damage (SLICC/American College of Rheumatology Damage Index [SDI]) and health-related quality of life (Short-Form 36 [SF-36] scores) were assessed. The SLICC-FI was constructed using baseline data. The SLICC-FI comprises 48 health deficits, including items related to organ damage, disease activity, comorbidities, and functional status. Content, construct, and criterion validity of the SLICC-FI were assessed. Multivariable Cox regression was used to estimate the association between baseline SLICC-FI values and mortality risk, adjusting for demographic and clinical factors.ResultsIn the baseline data set of 1,683 patients with SLE, 89% were female, the mean ± SD age was 35.7 ± 13.4 years, and the mean ± SD disease duration was 18.8 ± 15.7 months. At baseline, the mean ± SD SLICC-FI score was 0.17 ± 0.08 (range 0-0.51). Baseline SLICC-FI values exhibited the expected measurement properties and were weakly correlated with baseline SDI scores (r = 0.26, P < 0.0001). Higher baseline SLICC-FI values (per 0.05 increment) were associated with increased mortality risk (hazard ratio 1.59, 95% confidence interval 1.35-1.87), after adjusting for age, sex, steroid use, ethnicity/region, and baseline SDI scores.ConclusionThe SLICC-FI demonstrates internal validity as a health measure in SLE and might be used to predict future mortality risk. The SLICC-FI is potentially valuable for quantifying vulnerability among patients with SLE, and adds to existing prognostic scores.
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- 2019
20. Antinuclear Antibody–Negative Systemic Lupus Erythematosus in an International Inception Cohort
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Choi, May Y, Clarke, Ann E, St. Pierre, Yvan, Hanly, John G, Urowitz, Murray B, Romero‐Diaz, Juanita, Gordon, Caroline, Bae, Sang‐Cheol, Bernatsky, Sasha, Wallace, Daniel J, Merrill, Joan T, Isenberg, David A, Rahman, Anisur, Ginzler, Ellen M, Petri, Michelle, Bruce, Ian N, Dooley, Mary A, Fortin, Paul R, Gladman, Dafna D, Sanchez‐Guerrero, Jorge, Steinsson, Kristjan, Ramsey‐Goldman, Rosalind, Khamashta, Munther A, Aranow, Cynthia, Alarcón, Graciela S, Manzi, Susan, Nived, Ola, Zoma, Asad A, 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, Stoll, Thomas, Buyon, Jill, Mahler, Michael, and Fritzler, Marvin J
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Biomedical and Clinical Sciences ,Clinical Sciences ,Lupus ,Autoimmune Disease ,Inflammatory and immune system ,Adult ,Antibodies ,Antinuclear ,Biomarkers ,Female ,Fluorescent Antibody Technique ,Indirect ,Glucocorticoids ,Humans ,Immunosuppressive Agents ,Lupus Erythematosus ,Systemic ,Male ,Mitosis ,Predictive Value of Tests ,Prognosis ,Serologic Tests ,Public Health and Health Services ,Psychology ,Clinical sciences ,Allied health and rehabilitation science - Abstract
ObjectiveThe spectrum of antinuclear antibodies (ANAs) is changing to include both nuclear staining as well as cytoplasmic and mitotic cell patterns (CMPs) and accordingly a change is occurring in terminology to anticellular antibodies. This study examined the prevalence of indirect immunofluorescence (IIF) anticellular antibody staining using the Systemic Lupus International Collaborating Clinics inception cohort.MethodsAnticellular antibodies were detected by IIF on HEp-2000 substrate using the baseline serum. Three serologic subsets were examined: ANA positive (presence of either nuclear or mixed nuclear/CMP staining), anticellular antibody negative (absence of any intracellular staining), and isolated CMP staining. The odds of being anticellular antibody negative versus ANA or isolated CMP positive was assessed by multivariable analysis.ResultsA total of 1,137 patients were included; 1,049 (92.3%) were ANA positive, 71 (6.2%) were anticellular antibody negative, and 17 (1.5%) had an isolated CMP. The isolated CMP-positive group did not differ from the ANA-positive or anticellular antibody-negative groups in clinical, demographic, or serologic features. Patients who were older (odds ratio [OR] 1.02 [95% confidence interval (95% CI) 1.00, 1.04]), of white race/ethnicity (OR 3.53 [95% CI 1.77, 7.03]), or receiving high-dose glucocorticoids at or prior to enrollment (OR 2.39 [95% CI 1.39, 4.12]) were more likely to be anticellular antibody negative. Patients on immunosuppressants (OR 0.35 [95% CI 0.19, 0.64]) or with anti-SSA/Ro 60 (OR 0.41 [95% CI 0.23, 0.74]) or anti-U1 RNP (OR 0.43 [95% CI 0.20, 0.93]) were less likely to be anticellular antibody negative.ConclusionIn newly diagnosed systemic lupus erythematosus, 6.2% of patients were anticellular antibody negative, and 1.5% had an isolated CMP. The prevalence of anticellular antibody-negative systemic lupus erythematosus will likely decrease as emerging nomenclature guidelines recommend that non-nuclear patterns should also be reported as a positive ANA.
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- 2019
21. Psychosis in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study
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Hanly, John G, Li, Qiuju, Su, Li, Urowitz, Murray B, Gordon, Caroline, Bae, Sang-Cheol, Romero-Diaz, Juanita, Sanchez-Guerrero, Jorge, Bernatsky, Sasha, Clarke, Ann E, Wallace, Daniel J, Isenberg, David A, Rahman, Anisur, Merrill, Joan T, Fortin, Paul R, Gladman, Dafna D, Bruce, Ian N, Petri, Michelle, Ginzler, Ellen M, Dooley, MA, Steinsson, Kristjan, Ramsey-Goldman, Rosalind, Zoma, Asad A, Manzi, Susan, Nived, Ola, Jonsen, Andreas, Khamashta, Munther A, Alarcón, Graciela S, 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
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Biomedical and Clinical Sciences ,Clinical Sciences ,Lupus ,Clinical Research ,Autoimmune Disease ,Mental Health ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Inflammatory and immune system ,Adult ,Age Factors ,Antibodies ,Anticardiolipin ,Autoantibodies ,Cohort Studies ,Female ,Humans ,Kaplan-Meier Estimate ,Linear Models ,Lupus Coagulation Inhibitor ,Lupus Erythematosus ,Systemic ,Lupus Vasculitis ,Central Nervous System ,Male ,Middle Aged ,Proportional Hazards Models ,Prospective Studies ,Psychotic Disorders ,Receptors ,N-Methyl-D-Aspartate ,Sex Factors ,Young Adult ,beta 2-Glycoprotein I ,Immunology ,Public Health and Health Services ,Arthritis & Rheumatology ,Clinical sciences - Abstract
ObjectiveTo 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.MethodsPatients 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.ResultsOf 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.ConclusionPsychosis 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 good for most patients, although careful follow-up is required.
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- 2019
22. Performance of Modified ALMS and BLISS Criteria with Standard of Care Treatment in Two US Health Care Systems
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Khosroshahi, Arezou, Tong, David, Bao, Gaobin, Al‐Naqeeb, Jinan, Ghosh, Pranab, Peeva, Elena, Easley, Kirk A., Weiss, Roberta, and Lim, S. Sam
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- 2023
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23. Evaluating the Construct of Damage in Systemic Lupus Erythematosus
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Johnson, Sindhu R., Gladman, Dafna D., Brunner, Hermine I., Isenberg, David, Clarke, Ann E., Barber, Megan R. W., Arnaud, Laurent, Fortin, Paul R., Mosca, Marta, Voskuyl, Alexandre E., Manzi, Susan, Aranow, Cynthia, Askanase, Anca, Alarcón, Graciela S., Bae, Sang‐Cheol, Costedoat‐Chalumeau, Nathalie, English, Jessica A., Pons‐Estel, Guillermo J., Pons‐Estel, Bernardo A., Gilman, Rebecca, Ginzler, Ellen M., Hanly, John G., Jacobsen, Soren, Kalunian, Kenneth, Kamen, Diane L., Lambalgen, Chynace, Legge, Alexandra, Lim, S. Sam, Mak, Anselm, Morand, Eric F., Peschken, Christine A., Petri, Michelle, Rahman, Anisur, Ramsey‐Goldman, Rosalind, Reynolds, John A., Romero‐Diaz, Juanita, Ruiz‐Irastorza, Guillermo, Sanchez‐Guerrero, Jorge, Svenungsson, Elisabet, Touma, Zahi, Urowitz, Murray, Vinet, Evelyne, van Vollenhoven, Ronald F., Waldhauser, Heather, Wallace, Daniel J., Zoma, Asad, and Bruce, Ian N.
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- 2023
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24. Multiplicative Impact of Adverse Social Determinants of Health on Outcomes in Lupus Nephritis: A Meta‐analysis and Systematic Review.
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Garg, Shivani, Sweet, Nadia, Boderman, Brianna, Montes, Daniel, Walunas, Theresa, Ramsey‐Goldman, Rosalind, Khosroshahi, Arezou, Astor, Brad C., Lim, S. Sam, and Bartels, Christie M.
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SOCIAL determinants of health ,LUPUS nephritis ,HEALTH behavior ,BLACK people ,MEDICAL care - Abstract
Objective: Social determinants of health (SDoH) likely contribute to outcome disparities in lupus nephritis (LN). Understanding the overall burden and contribution of each domain could guide future health equity–focused interventions to improve outcomes and reduce disparities in LN. Objectives of this meta‐analysis were to 1) determine the association of overall SDoH and specific SDoH domains on LN outcomes and 2) develop a framework for the multidimensional impact of SDoH on LN outcomes. Methods: We performed a comprehensive search of studies measuring associations between SDoH and LN outcomes. We examined pooled odds of poor LN outcomes including death, end‐stage kidney disease, or cardiovascular disease in patients with and without adverse SDoH. Additionally, we calculated the pooled odds ratios of outcomes by four SDoH domains: individual (eg, insurance), health care (eg, fragmented care), community (eg, neighborhood socioeconomic status), and health behaviors (eg, smoking). Results: Among 531 screened studies, 31 meeting inclusion criteria and 13 with raw data were included in meta‐analysis. Pooled odds of poor outcomes were 1.47‐fold higher in patients with any adverse SDoH. Patients with adverse SDoH in individual and health care domains had 1.64‐fold and 1.77‐fold higher odds of poor outcomes. We found a multiplicative impact of having two or more adverse SDoH on LN outcomes. Black patients with public insurance and fragmented care had 12‐fold higher odds of poor LN outcomes. Conclusion: Adverse SDoH is associated with poor LN outcomes. Having two or more adverse SDoH, specifically in different SDoH domains, had a multiplicative impact leading to worse LN outcomes, widening disparities. [ABSTRACT FROM AUTHOR]
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- 2024
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25. Implementing a Staff‐Led Smoking Cessation Intervention in a Diverse Safety‐Net Rheumatology Clinic: A Pre‐Post Scalability Study in a Low‐Resource Setting.
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Brandt, Jennifer, Ramly, Edmond, Lim, S. Sam, Bao, Gaobin, Messina, Monica L., Piper, Megan E., and Bartels, Christie M.
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SMOKING cessation ,ELECTRONIC health records ,BLACK people ,MEDICAL care ,SMOKING - Abstract
Objective: Quit Connect (QC), our specialty clinic smoking cessation intervention, supports clinic staff to check, advise, and connect willing patients to a state quit line or class. QC improved tobacco screening and quit line referrals 26‐fold in a predominantly White academic health care system population. Implementing QC includes education, electronic health record (EHR) reminders, and periodic audit feedback. This study tested QC's feasibility and impact in a safety‐net rheumatology clinic with a predominantly Black population. Methods: In this pre‐post study, adult rheumatology visits were analyzed 12 months before through 18 months after QC intervention (November 2019 through November 2021, omitting COVID‐19 peak April through November 2020). EHR data compared process and clinical outcomes, including offers, referrals to resources, completed referrals, and documented cessation. Clinic staff engaged in pre‐post focus groups and questionnaires regarding intervention feasibility and acceptability. Cost‐effectiveness was also assessed. Results: Visit‐level patients who smoked were 89.8% Black and 69.5% women (n = 550). Before intervention, clinic staff rarely asked patients about readiness to cut back smoking (<10% assessment). After QC intervention, staff assessed quit readiness in 31.8% of visits with patients who smoked (vs 8.1% before); 58.9% of these patients endorsed readiness to cut back or quit. Of 102 accepting cessation services, 37% (n = 17) of those reached set a quit date. Staff found the intervention feasible and acceptable. Each quit attempt cost approximately $4 to $10. Conclusion: In a safety‐net rheumatology clinic with a predominantly Black population, QC improved tobacco screening, readiness‐to‐quit assessment, and referrals and was also feasible and cost‐effective. [ABSTRACT FROM AUTHOR]
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- 2024
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26. Anticipatory racism stress, smoking and disease activity: the Black women's experiences living with lupus (BeWELL) study
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Spears, Erica C., Allen, Amani M., Chung, Kara W., Martz, Connor D., Hunter, Evelyn A., Fuller-Rowell, Thomas E., and Lim, S. Sam
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Women, Black -- Health aspects -- Psychological aspects ,Systemic lupus erythematosus -- Risk factors -- Diagnosis -- Care and treatment ,Racism -- Psychological aspects -- Health aspects ,Behavior therapy -- Methods ,Smoking -- Health aspects ,Psychology and mental health - Abstract
African American women with systemic lupus erythematosus (SLE) have worse disease outcomes compared to their White counterparts. Stressors associated with race may contribute to poorer health in this population through maladaptive behavioral pathways. This study investigated relationships between stress associated with anticipating racism, smoking, and SLE disease activity. Data were from 432 African American women with SLE in the Black Women's Experiences Living with Lupus (BeWELL) Study. Controlling for sociodemographic and health-related covariates, multivariable regression analyses revealed a significant association between anticipatory racism stress (ARS) and disease activity (p = 0.00, b = 1.13, 95% CI [0.43, 1.82]). A significant interaction between ARS and smoking also indicated that smoking exacerbated the effect of ARS on disease activity (p = 0.04, b = 1.95, CI = 0.04, 3.96). Test for evidence of smoking mediating the effect of ARS on disease activity were not statistically significant (z = 1.77, p = 0.08). Findings have implications for future SLE disparities research among African American women with SLE., Author(s): Erica C. Spears [sup.1] , Amani M. Allen [sup.2] , Kara W. Chung [sup.3] , Connor D. Martz [sup.3] , Evelyn A. Hunter [sup.4] , Thomas E. Fuller-Rowell [sup.3] [...]
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- 2021
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27. Factors Associated With the Initiation and Retention of Patients With Lupus in the Chronic Disease Self‐Management Program
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Falasinnu, Titilola, Bao, Gaobin, Brady, Teresa J., Lim, S. Sam, and Drenkard, Cristina
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- 2023
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28. Cerebrovascular Events in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study
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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, 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
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Reproductive Medicine ,Biomedical and Clinical Sciences ,Autoimmune Disease ,Clinical Research ,Lupus ,Hematology ,Stroke ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Inflammatory and immune system ,Adult ,Cerebrovascular Disorders ,Female ,Humans ,Lupus Erythematosus ,Systemic ,Male ,Middle Aged ,Prospective Studies ,Quality of Life ,Young Adult ,Clinical Sciences ,Public Health and Health Services ,Psychology ,Clinical sciences ,Allied health and rehabilitation science - 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.
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- 2018
29. Economic Evaluation of Lupus Nephritis in the Systemic Lupus International Collaborating Clinics Inception Cohort Using a Multistate Model Approach
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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, 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
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Reproductive Medicine ,Biomedical and Clinical Sciences ,Clinical Sciences ,Lupus ,Kidney Disease ,Autoimmune Disease ,Clinical Research ,Burden of Illness ,Renal and urogenital ,Adult ,Cohort Studies ,Female ,Health Care Costs ,Humans ,Lupus Nephritis ,Male ,Middle Aged ,Models ,Economic ,Young Adult ,Public Health and Health Services ,Psychology ,Clinical sciences ,Allied health and rehabilitation science - 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) 60 ml/minute) or with LN and estimated proteinuria >3 gm/day ($84,040 versus $20,499 if no LN and estimated proteinuria
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- 2018
30. Comparison of cognitive performance measures in individuals with systemic lupus erythematosus
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Plantinga, Laura, primary, Yazdany, Jinoos, additional, Bowling, C Barrett, additional, Dunlop-Thomas, Charmayne, additional, Hoge, Courtney, additional, Pearce, Brad D, additional, Lim, S Sam, additional, and Katz, Patricia, additional
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- 2024
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31. Comprehension, Utility, and Acceptability of a Multidomain Physical Functioning Report for Systemic Lupus Erythematosus Patients and Their Providers
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Plantinga, Laura C., Xu, Grace, Hoge, Courtney, Vandenberg, Ann, Dunlop‐Thomas, Charmayne, Jones, Brian D., Johnson, Jeremy, Drenkard, Cristina, Lim, S. Sam, and Bowling, C. Barrett
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- 2023
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32. Introduction to the Special Theme Issue: Heath Disparities and Health Equity in the Rheumatic Diseases
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Allen, Kelli D. and Lim, S. Sam
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- 2023
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33. Pathways linking census tract typologies with subjective neighborhood disorder and depressive symptoms in the Black Women's Experiences Living with Lupus (BeWELL) Study
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Martz, Connor D., Hunter, Evelyn A., Kramer, Michael R., Wang, Yijie, Chung, Kara, Brown, Michael, Drenkard, Cristina, Lim, S. Sam, and Chae, David H.
- Published
- 2021
- Full Text
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34. Cognitive Problems and Their Clinical Assessment in Systemic Lupus Erythematosus: Contrasting Patient and Provider Views
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Vandenberg, Ann E., Drenkard, Cristina, Goldstein, Felicia C., Dunlop‐Thomas, Charmayne, Lim, S. Sam, Bowling, C. Barrett, and Plantinga, Laura C.
- Published
- 2022
- Full Text
- View/download PDF
35. Adverse Perinatal Outcomes Before and After Diagnosis of Systemic Lupus Erythematosus Among African American Women
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Angley, Meghan, Drews‐Botsch, Carolyn, Lewis, Tené T., Badell, Martina, Lim, S. Sam, and Howards, Penelope P.
- Published
- 2022
- Full Text
- View/download PDF
36. A Longitudinal Analysis of Outcomes of Lupus Nephritis in an International Inception Cohort Using a Multistate Model Approach
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Hanly, John G, Su, Li, Urowitz, Murray B, Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Bernatsky, Sasha, Clarke, Ann E, Wallace, Daniel J, Merrill, Joan T, Isenberg, David A, Rahman, Anisur, Ginzler, Ellen M, Petri, Michelle, Bruce, Ian N, Dooley, MA, Fortin, Paul, Gladman, Dafna D, Sanchez-Guerrero, Jorge, Steinsson, Kristjan, Ramsey-Goldman, Rosalind, Khamashta, Munther A, Aranow, Cynthia, Alarcón, Graciela S, Fessler, Barri J, Manzi, Susan, Nived, Ola, Sturfelt, Gunnar K, Zoma, Asad A, van Vollenhoven, Ronald F, Ramos-Casals, Manuel, Ruiz-Irastorza, Guillermo, Lim, S Sam, Kalunian, Kenneth C, Inanc, Murat, Kamen, Diane L, Peschken, Christine A, Jacobsen, Soren, Askanase, Anca, Theriault, Chris, and Farewell, Vernon
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Kidney Disease ,Autoimmune Disease ,Lupus ,Clinical Research ,Adult ,Female ,Glomerular Filtration Rate ,Humans ,Internationality ,Kidney Failure ,Chronic ,Longitudinal Studies ,Lupus Nephritis ,Male ,Models ,Statistical ,Proteinuria ,Immunology ,Public Health and Health Services ,Arthritis & Rheumatology ,Clinical sciences - Abstract
ObjectiveTo study bidirectional change and predictors of change in estimated glomerular filtration rate (GFR) and proteinuria in lupus nephritis (LN) using a multistate modeling approach.MethodsPatients in the Systemic Lupus International Collaborating Clinics inception cohort were classified annually into estimated GFR state 1 (>60 ml/minute), state 2 (30-60 ml/minute), or state 3 (3.0 gm/day), or end-stage renal disease (ESRD) or death. Using multistate modeling, relative transition rates between states indicated improvement and deterioration.ResultsOf 1,826 lupus patients, 700 (38.3%) developed LN. During a mean ± SD follow-up of 5.2 ± 3.5 years, the likelihood of improvement in estimated GFR and estimated proteinuria was greater than the likelihood of deterioration. After 5 years, 62% of patients initially in estimated GFR state 3 and 11% of patients initially in estimated proteinuria state 3 transitioned to ESRD. The probability of remaining in the initial states 1, 2, and 3 was 85%, 11%, and 3%, respectively, for estimated GFR and 62%, 29%, and 4%, respectively, for estimated proteinuria. Male sex predicted improvement in estimated GFR states; older age, race/ethnicity, higher estimated proteinuria state, and higher renal biopsy chronicity scores predicted deterioration. For estimated proteinuria, race/ethnicity, earlier calendar years, damage scores without renal variables, and higher renal biopsy chronicity scores predicted deterioration; male sex, presence of lupus anticoagulant, class V nephritis, and mycophenolic acid use predicted less improvement.ConclusionIn LN, the expected improvement or deterioration in renal outcomes can be estimated by multistate modeling and is preceded by identifiable risk factors. New therapeutic interventions for LN should meet or exceed these expectations.
- Published
- 2016
37. The frequency and outcome of lupus nephritis: results from an international inception cohort study
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Hanly, John G, O'Keeffe, Aidan G, Su, Li, Urowitz, Murray B, Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Bernatsky, Sasha, Clarke, Ann E, Wallace, Daniel J, Merrill, Joan T, Isenberg, David A, Rahman, Anisur, Ginzler, Ellen M, Fortin, Paul, Gladman, Dafna D, Sanchez-Guerrero, Jorge, Petri, Michelle, Bruce, Ian N, Dooley, Mary Anne, Ramsey-Goldman, Rosalind, Aranow, Cynthia, Alarcón, Graciela S, Fessler, Barri J, Steinsson, Kristjan, Nived, Ola, Sturfelt, Gunnar K, Manzi, Susan, Khamashta, Munther A, van Vollenhoven, Ronald F, Zoma, Asad A, Ramos-Casals, Manuel, Ruiz-Irastorza, Guillermo, Lim, S Sam, Stoll, Thomas, Inanc, Murat, Kalunian, Kenneth C, Kamen, Diane L, Maddison, Peter, Peschken, Christine A, Jacobsen, Soren, Askanase, Anca, Theriault, Chris, Thompson, Kara, and Farewell, Vernon
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Kidney Disease ,Lupus ,Prevention ,Human Genome ,Mental Health ,Autoimmune Disease ,Genetics ,Clinical Research ,Behavioral and Social Science ,Good Health and Well Being ,Adult ,Disease Progression ,Ethnicity ,Female ,Follow-Up Studies ,Global Health ,Humans ,Incidence ,Lupus Nephritis ,Male ,Outcome Assessment ,Health Care ,Prospective Studies ,Quality of Life ,Risk Factors ,Surveys and Questionnaires ,Survival Rate ,systemic lupus erythematosus ,lupus ,nephritis ,inception cohort ,outcomes research ,Immunology ,Public Health and Health Services ,Arthritis & Rheumatology ,Clinical sciences - Abstract
ObjectiveTo determine nephritis outcomes in a prospective multi-ethnic/racial SLE inception cohort.MethodsPatients in the Systemic Lupus International Collaborating Clinics inception cohort (≤15 months of SLE diagnosis) were assessed annually for estimated glomerular filtration rate (eGFR), proteinuria and end-stage renal disease (ESRD). Health-related quality of life was measured by the Short Form (36 questions) health survey questionnaire (SF-36) subscales, mental and physical component summary scores.ResultsThere were 1827 patients, 89% females, mean (s.d.) age 35.1 (13.3) years. The mean (s.d.) SLE duration at enrolment was 0.5 (0.3) years and follow-up 4.6 (3.4) years. LN occurred in 700 (38.3%) patients: 566/700 (80.9%) at enrolment and 134/700 (19.1%) during follow-up. Patients with nephritis were younger, more frequently men and of African, Asian and Hispanic race/ethnicity. The estimated overall 10-year incidence of ESRD was 4.3% (95% CI: 2.8%, 5.8%), and with nephritis was 10.1% (95% CI: 6.6%, 13.6%). Patients with nephritis had a higher risk of death (HR = 2.98, 95% CI: 1.48, 5.99; P = 0.002) and those with eGFR
- Published
- 2016
38. Association Between Severe Nonadherence to Hydroxychloroquine and Systemic Lupus Erythematosus Flares, Damage, and Mortality in 660 Patients From the SLICC Inception Cohort
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Nguyen, Yann, primary, Blanchet, Benoît, additional, Urowitz, Murray B., additional, Hanly, John G., additional, Gordon, Caroline, additional, Bae, Sang‐Cheol, additional, Romero‐Diaz, Juanita, additional, Sanchez‐Guerrero, Jorge, additional, Clarke, Ann E., additional, Bernatsky, Sasha, 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, Le Guern, Véronique, additional, Mackay, Meggan, additional, Ruiz‐Irastorza, Guillermo, additional, Lim, S. Sam, additional, Inanc, Murat, additional, Kalunian, Kenneth C., additional, Jacobsen, Søren, additional, Peschken, Christine A., additional, Kamen, Diane L., additional, Askanase, Anca, additional, Buyon, Jill, additional, and Costedoat‐Chalumeau, Nathalie, additional
- Published
- 2023
- Full Text
- View/download PDF
39. Vicarious Racism Stress and Disease Activity : the Black Women’s Experiences Living with Lupus (BeWELL) Study
- Author
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Martz, Connor D., Allen, Amani M., Fuller-Rowell, Thomas E., Spears, Erica C., Lim, S. Sam, Drenkard, Cristina, Chung, Kara, Hunter, Evelyn A., and Chae, David H.
- Published
- 2019
40. Racial Disparities in Mortality Associated with Systemic Lupus Erythematosus — Fulton and DeKalb Counties, Georgia, 2002–2016
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Lim, S. Sam, Helmick, Charles G., Bao, Gaobin, Hootman, Jennifer, Bayakly, Rana, Gordon, Caroline, and Drenkard, Cristina
- Published
- 2019
41. Impact of early disease factors on metabolic syndrome in systemic lupus erythematosus: data from an international inception cohort
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Parker, Ben, Urowitz, Murray B, Gladman, Dafna D, Lunt, Mark, Donn, Rachelle, Bae, Sang-Cheol, Sanchez-Guerrero, Jorge, Romero-Diaz, Juanita, Gordon, Caroline, Wallace, Daniel J, Clarke, Ann E, Bernatsky, Sasha, Ginzler, Ellen M, Isenberg, David A, Rahman, Anisur, Merrill, Joan T, Alarcón, Graciela S, Fessler, Barri J, Fortin, Paul R, Hanly, John G, Petri, Michelle, Steinsson, Kristjan, Dooley, Mary Anne, Manzi, Susan, Khamashta, Munther A, Ramsey-Goldman, Rosalind, Zoma, Asad A, Sturfelt, Gunnar K, Nived, Ola, Aranow, Cynthia, Mackay, Meggan, Ramos-Casals, Manuel, van Vollenhoven, Ronald F, Kalunian, Kenneth C, Ruiz-Irastorza, Guillermo, Lim, S Sam, Kamen, Diane L, Peschken, Christine A, Inanc, Murat, and Bruce, Ian N
- Subjects
Clinical Research ,Lupus ,Autoimmune Disease ,Kidney Disease ,Prevention ,Cardiovascular ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Inflammatory and immune system ,Good Health and Well Being ,Adult ,Cohort Studies ,Comorbidity ,Female ,Humans ,Logistic Models ,Lupus Erythematosus ,Systemic ,Male ,Metabolic Syndrome ,Middle Aged ,Phenotype ,Prevalence ,Young Adult ,Cardiovascular Disease ,Inflammation ,Systemic Lupus Erythematosus ,Clinical Sciences ,Immunology ,Public Health and Health Services ,Arthritis & Rheumatology - Abstract
BackgroundThe metabolic syndrome (MetS) may contribute to the increased cardiovascular risk in systemic lupus erythematosus (SLE). We examined the association between MetS and disease activity, disease phenotype and corticosteroid exposure over time in patients with SLE.MethodsRecently diagnosed (1, higher disease activity, increasing age and Hispanic or Black African race/ethnicity were independently associated with MetS over the first 2 years of follow-up in the cohort.ConclusionsMetS is a persistent phenotype in a significant proportion of patients with SLE. Renal lupus, active inflammatory disease and damage are SLE-related factors that drive MetS development while antimalarial agents appear to be protective from early in the disease course.
- Published
- 2015
42. End‐Stage Renal Disease in African Americans With Lupus Nephritis Is Associated With APOL1
- Author
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Freedman, Barry I, Langefeld, Carl D, Andringa, Kelly K, Croker, Jennifer A, Williams, Adrienne H, Garner, Neva E, Birmingham, Daniel J, Hebert, Lee A, Hicks, Pamela J, Segal, Mark S, Edberg, Jeffrey C, Brown, Elizabeth E, Alarcón, Graciela S, Costenbader, Karen H, Comeau, Mary E, Criswell, Lindsey A, Harley, John B, James, Judith A, Kamen, Diane L, Lim, S Sam, Merrill, Joan T, Sivils, Kathy L, Niewold, Timothy B, Patel, Neha M, Petri, Michelle, Ramsey‐Goldman, Rosalind, Reveille, John D, Salmon, Jane E, Tsao, Betty P, Gibson, Keisha L, Byers, Joyce R, Vinnikova, Anna K, Lea, Janice P, Julian, Bruce A, Kimberly, Robert P, and Consortium, on behalf of the Lupus Nephritis–End‐Stage Renal Disease
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Genetics ,Kidney Disease ,Genetic Testing ,Clinical Research ,Autoimmune Disease ,Lupus ,Aetiology ,2.1 Biological and endogenous factors ,Inflammatory and immune system ,Adult ,Black or African American ,Alleles ,Apolipoprotein L1 ,Apolipoproteins ,Disease Progression ,Female ,Genetic Predisposition to Disease ,Genotype ,Humans ,Kidney Failure ,Chronic ,Lipoproteins ,HDL ,Logistic Models ,Lupus Nephritis ,Male ,Middle Aged ,Risk Factors ,White People ,Lupus Nephritis–End‐Stage Renal Disease Consortium ,Immunology ,Public Health and Health Services ,Arthritis & Rheumatology ,Clinical sciences - Abstract
ObjectiveLupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus (SLE) that exhibits familial aggregation and may progress to end-stage renal disease (ESRD). LN is more prevalent among African Americans than among European Americans. This study was undertaken to investigate the hypothesis that the apolipoprotein L1 gene (APOL1) nephropathy risk alleles G1/G2, common in African Americans and rare in European Americans, contribute to the ethnic disparity in risk.MethodsAPOL1 G1 and G2 nephropathy alleles were genotyped in 855 African American SLE patients with LN-ESRD (cases) and 534 African American SLE patients without nephropathy (controls) and tested for association under a recessive genetic model, by logistic regression.ResultsNinety percent of the SLE patients were female. The mean ± SD age at SLE diagnosis was significantly lower in LN-ESRD cases than in SLE non-nephropathy controls (27.3 ± 10.9 years versus 39.5 ± 12.2 years). The mean ± SD time from SLE diagnosis to development of LN-ESRD in cases was 7.3 ± 7.2 years. The G1/G2 risk alleles were strongly associated with SLE-ESRD, with 25% of cases and 12% of controls having 2 nephropathy alleles (odds ratio [OR] 2.57, recessive model P = 1.49 × 10(-9)), and after adjustment for age, sex, and ancestry admixture (OR 2.72, P = 6.23 × 10(-6)). The age-, sex-, and admixture-adjusted population attributable risk for ESRD among patients with G1/G2 polymorphisms was 0.26, compared to 0.003 among European American patients. The mean time from SLE diagnosis to ESRD development was ∼2 years earlier among individuals with APOL1 risk genotypes (P = 0.01).ConclusionAPOL1 G1/G2 alleles strongly impact the risk of LN-ESRD in African Americans, as well as the time to progression to ESRD. The high frequency of these alleles in African Americans with near absence in European Americans explains an important proportion of the increased risk of LN-ESRD in African Americans.
- Published
- 2014
43. Mood Disorders in Systemic Lupus Erythematousus (SLE): Results from an International, Inception Cohort Study.
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Hanly, John G, Su, Li, Urowitz, Murray, Romero-Diaz, Juanita, Gordon, Caroline, Bae, Sang-Cheol, Bernatsky, Sasha R, Clarke, Ann E, Wallace, Daniel J, Merrill, Joan T, Isenberg, David A, Rahman, Anisur, Ginzler, Ellen M, Fortin, Paul, Gladman, Dafna D, Sanchez-Guerrero, Jorge, Petri, Michelle A, Bruce, Ian, Dooley, Mary Anne, Ramsey-Goldman, Rosalind, Aranow, Cynthia, Alarcon, Graciela S, Fessler, Barri J, Steinsson, Kristjan, Nived, Ola, Sturfelt, Gunnar K, Manzi, Susan, Khamashta, Munther A, van Vollenhoven, Ronald F, Zoma, Asad, Ramos-Casals, Manuel, Ruiz-Irastorza, Guillermo, Lim, S Sam, Stoll, Thomas, Inanc, Murat, Kalunian, Kenneth C, Kamen, Diane L, Maddison, Peter, Peschken, Christine A, Jacobsen, Soren, Askanase, Anca, Buyon, Jill P, Theriault, Chris, Thompson, Kara, and Farewell, Vernon
- Subjects
Clinical Sciences ,Immunology ,Public Health and Health Services ,Arthritis & Rheumatology - Published
- 2014
44. Physical Performance in a Diverse, Population‐based Cohort of Individuals with Systemic Lupus Erythematosus
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Plantinga, Laura C., primary, Bowling, C. Barrett, additional, Hoge, Courtney, additional, Dunlop‐Thomas, Charmayne, additional, Pearce, Bradley D., additional, Lim, S. Sam, additional, and Drenkard, Cristina, additional
- Published
- 2023
- Full Text
- View/download PDF
45. Feasibility and Utility of a Pilot Peer Education Program to Improve Patient Engagement in Lupus Clinical Trials: Implementation and Evaluation in a Multisite Model Within a Lupus Clinical Trials Network
- Author
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Sheikh, Saira Z., primary, Donovan, Caroline, additional, Menezes, Carla, additional, Roy, Albert T., additional, Simkus, Andrew, additional, Gross, Diane, additional, Askanase, Anca, additional, Ramsey‐Goldman, Rosalind, additional, Majithia, Vikas, additional, Wanty, Nicole, additional, McNeill, Annie, additional, Holtz, Kristen, additional, and Lim, S. Sam, additional
- Published
- 2023
- Full Text
- View/download PDF
46. Introduction to the Special Theme Issue: COVID‐19 & Rheumatology: Emerging Insights and Impacts
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Brady, Teresa J., primary, Lim, S. Sam, additional, and Allen, Kelli D., additional
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- 2023
- Full Text
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47. Disparities in Lupus and the Role of Social Determinants of Health: Current State of Knowledge and Directions for Future Research
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Buie, Joy, primary, McMillan, Emma, additional, Kirby, Jillian, additional, Cardenas, Leigh Ann, additional, Eftekhari, Sanaz, additional, Feldman, Candace H., additional, Gawuga, Cyrena, additional, Knight, Andrea M., additional, Lim, S. Sam, additional, McCalla, Sheryl, additional, McClamb, Daria, additional, Polk, Barbara, additional, Williams, Edith, additional, Yelin, Ed, additional, Shah, Sanoja, additional, and Costenbader, Karen H., additional
- Published
- 2023
- Full Text
- View/download PDF
48. Arthritis Care & Research
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Allen, Kelli D., Lim, S. Sam, and Schwartz, Todd A.
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- 2021
- Full Text
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49. Chronic Cutaneous Lupus Erythematosus: Depression Burden and Associated Factors
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Hong, Jennifer, Aspey, Laura, Bao, Gaobin, Haynes, Tamara, Lim, S. Sam, and Drenkard, Cristina
- Published
- 2019
- Full Text
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50. Physical Performance in a Diverse, Population‐BasedCohort of Individuals With Systemic Lupus Erythematosus
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Plantinga, Laura C., Bowling, C. Barrett, Hoge, Courtney, Dunlop‐Thomas, Charmayne, Pearce, Bradley D., Lim, S. Sam, and Drenkard, Cristina
- Abstract
To report the burden and correlates of poor physical performance in a diverse cohort of individuals with systemic lupus erythematosus (SLE). In this single‐visit study of 446 individuals with SLE from a population‐based metropolitan Atlanta cohort, we measured physical performance via the Short Physical Performance Battery (score range 0–12; intermediate‐low [<10] vs high [≥10]). We also collected demographic, clinical, and psychosocial variables and examined the associations (adjusted odds ratios [aORs]) of intermediate‐low versus high physical performance with these characteristics via multivariable logistic regression. We found that more than half (59.6%) of our participants had poorer (intermediate‐low) overall physical performance. Only 7% of the cohort received the maximum score on the lower body strength task versus 90% and 76% receiving the maximum scores on balance and gait speed tasks. Current employment status (aOR 0.69, 95% confidence interval [CI] 0.45–1.05) and higher cognitive functioning (aOR 0.57, 95% CI 0.42–0.77) were strongly associated with lower odds of intermediate‐low physical performance. Higher body mass index (aOR 1.25, 95% CI 1.01–1.56), disease activity (aOR 1.59, 95% CI 1.27–1.98), and disease burden (aOR 1.38, 95% CI 1.08–1.77) were associated with poorer performance, as were higher depressive symptoms, perceived stress scores, and lower educational attainment (not statistically significant). In our population‐based, primarily Black cohort, we found that individuals with SLE commonly had poor physical performance. We identified both SLE‐ and non‐SLE–specific factors that could help clinicians identify those most at risk for poor physical performance and intervene to improve, maintain, and support physical performance among those with SLE.
- Published
- 2024
- Full Text
- View/download PDF
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