First month prednisone dose predicts prednisone burden during the following 11 months: An observational study from the RELES cohort
Ruiz-Irastorza, G. ; Garcia, M. ; Espinosa, G. ; Caminal, L. ; Mitjavila, F. ; González-León, R. ; Sopenã, B. ; Canora, J. ; Villalba, M.V. ; Rodríguez-Carballeira, M. ; López-Dupla, J.M. ; Callejas, J.L. ; Castro, A. ; Tolosa, C. ; Sánchez-Garciá, M.E. ; Pérez-Conesa, M. (Universidad de Zaragoza) ; Navarrete-Navarrete, N. ; Rodríguez, A.P. ; Herranz, M.T. ; Pallarés, L.
Resumen: Aim: To study the influence of prednisone dose during the first month after systemic lupus erythematosus (SLE) diagnosis (prednisone-1) on glucocorticoid burden during the subsequent 11 months (prednisone-2–12). Methods: 223 patients from the Registro Español de Lupus Eritematoso Sistémico inception cohort were studied. The cumulative dose of prednisone-1 and prednisone-2–12 were calculated and recoded into a four-level categorical variable: no prednisone, low dose (up to 7.5 mg/day), medium dose (up to 30 mg/day) and high dose (over 30 mg/day). The association between the cumulative prednisone-1 and prednisone-2–12 doses was tested. We analysed whether the four-level prednisone-1 categorical variable was an independent predictor of an average dose >7.5 mg/day of prednisone-2–12. Adjusting variables included age, immunosuppressives, antimalarials, methyl-prednisolone pulses, lupus nephritis and baseline SLE Disease Activity Index (SLEDAI). Results: Within the first month, 113 patients (51%) did not receive any prednisone, 24 patients (11%) received average low doses, 46 patients (21%) received medium doses and 40 patients (18%) received high doses. There was a strong association between prednisone-1 and prednisone-2–12 dose categories (p<0.001). The cumulative prednisone-1 dose was directly associated with the cumulative prednisone-2–12 dose (p<0.001). Compared with patients on no prednisone, patients taking medium (adjusted OR 5.27, 95% CI 2.18 to 12.73) or high-dose prednisone-1 (adjusted OR 10.5, 95% CI 3.8 to 29.17) were more likely to receive prednisone-2–12 doses of >7.5 mg/day, while patients receiving low-dose prednisone-1 were not (adjusted OR 1.4, 95% CI 0. 0.38 to 5.2). If the analysis was restricted to the 158 patients with a baseline SLEDAI of =6, the model did not change. Conclusion: The dose of prednisone during the first month after the diagnosis of SLE is an independent predictor of prednisone burden during the following 11 months.
Idioma: Inglés
DOI: 10.1136/lupus-2016-000153
Año: 2016
Publicado en: Lupus Science and Medicine 3, 1 (2016), e000153 [6 pp]
ISSN: 2053-8790
Factor impacto SCIMAGO: 1.248 - Medicine (miscellaneous) (Q1) - Immunology (Q2)
Tipo y forma: Article (Published version)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes.
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Idioma: Inglés
DOI: 10.1136/lupus-2016-000153
Año: 2016
Publicado en: Lupus Science and Medicine 3, 1 (2016), e000153 [6 pp]
ISSN: 2053-8790
Factor impacto SCIMAGO: 1.248 - Medicine (miscellaneous) (Q1) - Immunology (Q2)
Tipo y forma: Article (Published version)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. Exportado de SIDERAL (2020-02-21-13:51:04)
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Record created 2016-12-15, last modified 2020-02-21