Impact of glucocorticoids on the incidence of lupus-related major organ damage : A systematic literature review and meta-regression analysis of longitudinal observational studies
(2021) In Lupus Science and Medicine 8(1).- Abstract
Objective In systemic lupus erythematosus (SLE), disease activity and glucocorticoid (GC) exposure are known to contribute to irreversible organ damage. We aimed to examine the association between GC exposure and organ damage occurrence. Methods We conducted a literature search (PubMed (Medline), Embase and Cochrane January 1966-October 2021). We identified original longitudinal observational studies reporting GC exposure as the proportion of users and/or GC use with dose information as well as the occurrence of new major organ damage as defined in the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Meta-regression analyses were performed. Reviews, case-reports and studies with <5... (More)
Objective In systemic lupus erythematosus (SLE), disease activity and glucocorticoid (GC) exposure are known to contribute to irreversible organ damage. We aimed to examine the association between GC exposure and organ damage occurrence. Methods We conducted a literature search (PubMed (Medline), Embase and Cochrane January 1966-October 2021). We identified original longitudinal observational studies reporting GC exposure as the proportion of users and/or GC use with dose information as well as the occurrence of new major organ damage as defined in the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Meta-regression analyses were performed. Reviews, case-reports and studies with <5 years of follow-up, <50 patients, different outcomes and special populations were excluded. Results We selected 49 articles including 16 224 patients, 14 755 (90.9%) female with a mean age and disease duration of 35.1 years and of 37.1 months. The mean follow-up time was 104.9 months. For individual damage items, the average daily GC dose was associated with the occurrence of overall cardiovascular events and with osteoporosis with fractures. A higher average cumulative dose adjusted (or not)/number of follow-up years and a higher proportion of patients on GC were associated with the occurrence of osteonecrosis. Conclusions We confirm associations of GC use with three specific damage items. In treating patients with SLE, our aim should be to maximise the efficacy of GC and to minimise their harms.
(Less)
- author
- organization
- publishing date
- 2021-12-20
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- glucocorticoids, health care, lupus erythematosus, outcome assessment, systemic
- in
- Lupus Science and Medicine
- volume
- 8
- issue
- 1
- article number
- e000590
- publisher
- BMJ Publishing Group
- external identifiers
-
- scopus:85122251038
- pmid:34930819
- ISSN
- 2053-8790
- DOI
- 10.1136/lupus-2021-000590
- language
- English
- LU publication?
- yes
- id
- c16c6ad9-7911-4d51-be86-d0078aec51dc
- date added to LUP
- 2022-03-08 14:04:14
- date last changed
- 2024-05-26 07:59:36
@article{c16c6ad9-7911-4d51-be86-d0078aec51dc,
abstract = {{<p>Objective In systemic lupus erythematosus (SLE), disease activity and glucocorticoid (GC) exposure are known to contribute to irreversible organ damage. We aimed to examine the association between GC exposure and organ damage occurrence. Methods We conducted a literature search (PubMed (Medline), Embase and Cochrane January 1966-October 2021). We identified original longitudinal observational studies reporting GC exposure as the proportion of users and/or GC use with dose information as well as the occurrence of new major organ damage as defined in the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Meta-regression analyses were performed. Reviews, case-reports and studies with <5 years of follow-up, <50 patients, different outcomes and special populations were excluded. Results We selected 49 articles including 16 224 patients, 14 755 (90.9%) female with a mean age and disease duration of 35.1 years and of 37.1 months. The mean follow-up time was 104.9 months. For individual damage items, the average daily GC dose was associated with the occurrence of overall cardiovascular events and with osteoporosis with fractures. A higher average cumulative dose adjusted (or not)/number of follow-up years and a higher proportion of patients on GC were associated with the occurrence of osteonecrosis. Conclusions We confirm associations of GC use with three specific damage items. In treating patients with SLE, our aim should be to maximise the efficacy of GC and to minimise their harms. </p>}},
author = {{Ugarte-Gil, Manuel Francisco and Mak, Anselm and Leong, Joanna and Dharmadhikari, Bhushan and Kow, Nien Yee and Reátegui-Sokolova, Cristina and Elera-Fitzcarrald, Claudia and Aranow, Cinthia and Arnaud, Laurent and Askanase, Anca D. and Bae, Sang Cheol and Bernatsky, Sasha and Bruce, Ian N. and Buyon, Jill and Costedoat-Chalumeau, Nathalie and Dooley, Mary Ann and Fortin, Paul R. and Ginzler, Ellen M. and Gladman, Dafna D. and Hanly, John and Inanc, Murat and Isenberg, David and Jacobsen, Soren and James, Judith A. and Jönsen, Andreas and Kalunian, Kenneth and Kamen, Diane L. and Lim, Sung Sam and Morand, Eric and Mosca, Marta and Peschken, Christine and Pons-Estel, Bernardo A. and Rahman, Anisur and Ramsey-Goldman, Rosalind and Reynolds, John and Romero-Diaz, Juanita and Ruiz-Irastorza, Guillermo and Sánchez-Guerrero, Jorge and Svenungsson, Elisabet and Urowitz, Murray and Vinet, Evelyne and Van Vollenhoven, Ronald F. and Voskuyl, Alexandre and Wallace, Daniel J. and Petri, Michelle A. and Manzi, Susan and Clarke, Ann Elaine and Cheung, Mike and Farewell, Vernon and Alarcon, Graciela S.}},
issn = {{2053-8790}},
keywords = {{glucocorticoids; health care; lupus erythematosus; outcome assessment; systemic}},
language = {{eng}},
month = {{12}},
number = {{1}},
publisher = {{BMJ Publishing Group}},
series = {{Lupus Science and Medicine}},
title = {{Impact of glucocorticoids on the incidence of lupus-related major organ damage : A systematic literature review and meta-regression analysis of longitudinal observational studies}},
url = {{http://dx.doi.org/10.1136/lupus-2021-000590}},
doi = {{10.1136/lupus-2021-000590}},
volume = {{8}},
year = {{2021}},
}