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

Little, Jayne; Parker, Ben; Lunt, Mark; Hanly, John G.; Urowitz, Murray B.; Clarke, Ann E.; Romero-Diaz, Juanita; Gordon, Caroline; Bae, Sang Cheol and Bernatsky, Sasha, et al. (2018) In Rheumatology (United Kingdom) 57(4). p.677-687
Abstract

Objectives. To describe glucocorticoid (GC) use in the SLICC inception cohort and to explore factors associated with GC use. In particular we aimed to assess temporal trends in GC use and to what extent physician-related factors may influence use. Methods. Patients were recruited within 15 months of diagnosis of SLE from 33 centres between 1999 and 2011 and continue to be reviewed annually. Descriptive statistics were used to detail oral and parenteral GC use. Cross sectional and longitudinal analyses were performed to explore factors associated with GC use at enrolment and over time. Results. We studied 1700 patients with a mean (S.D.) follow-up duration of 7.26 (3.82) years. Over the entire study period, 1365 (81.3%) patients received... (More)

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

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organization
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type
Contribution to journal
publication status
published
subject
keywords
Epidemiology, Glucocorticoids, Systemic lupus erythematosus
in
Rheumatology (United Kingdom)
volume
57
issue
4
pages
11 pages
publisher
Oxford University Press
external identifiers
  • scopus:85045074075
ISSN
1462-0324
DOI
10.1093/rheumatology/kex444
language
English
LU publication?
yes
id
04e51085-6ebc-4e82-9279-ab6ed59c12e7
date added to LUP
2018-04-20 13:30:22
date last changed
2019-07-16 03:48:13
@article{04e51085-6ebc-4e82-9279-ab6ed59c12e7,
  abstract     = {<p>Objectives. To describe glucocorticoid (GC) use in the SLICC inception cohort and to explore factors associated with GC use. In particular we aimed to assess temporal trends in GC use and to what extent physician-related factors may influence use. Methods. Patients were recruited within 15 months of diagnosis of SLE from 33 centres between 1999 and 2011 and continue to be reviewed annually. Descriptive statistics were used to detail oral and parenteral GC use. Cross sectional and longitudinal analyses were performed to explore factors associated with GC use at enrolment and over time. Results. We studied 1700 patients with a mean (S.D.) follow-up duration of 7.26 (3.82) years. Over the entire study period, 1365 (81.3%) patients received oral GCs and 447 (26.3%) received parenteral GCs at some point. GC use was strongly associated with treatment centre, age, race/ethnicity, sex, disease duration and disease activity. There was no change in the proportion of patients on GCs or the average doses of GC used over time according to year of diagnosis. Conclusion. GCs remain a cornerstone in SLE management and there have been no significant changes in their use over the past 10-15 years. While patient and disease factors contribute to the variation in GC use, between-centre differences suggest that physician-related factors also contribute. Evidence-based treatment algorithms are needed to inform a more standardized approach to GC use in SLE.</p>},
  author       = {Little, Jayne and Parker, Ben and Lunt, Mark and Hanly, John G. and Urowitz, Murray B. and Clarke, Ann E. and Romero-Diaz, Juanita and Gordon, Caroline and Bae, Sang Cheol and Bernatsky, Sasha and Wallace, Daniel J. and Merrill, Joan T. and Buyon, Jill and Isenberg, David A. and Rahman, Anisur and Ginzler, Ellen M. and Petri, Michelle and Dooley, Mary Anne and Fortin, Paul and Gladman, Dafna D. and Steinsson, Kristjan and Ramsey-Goldman, Rosalind and Khamashta, Munther A. and Aranow, Cynthia and Mackay, Meggan and Alarcón, Graciela S. and Manzi, Susan and Nived, Ola and Jönsen, Andreas and Zoma, Asad A. and van Vollenhoven, Ronald F. and Ramos-Casals, Manuel and Ruiz-Irastorza, Guillermo and Lim, Sung Sam and Kalunian, Kenneth C. and Inanc, Murat and Kamen, Diane L. and Peschken, Christine A. and Jacobsen, Soren and Askanase, Anca and Sanchez-Guerrero, Jorge and Bruce, Ian N.},
  issn         = {1462-0324},
  keyword      = {Epidemiology,Glucocorticoids,Systemic lupus erythematosus},
  language     = {eng},
  month        = {04},
  number       = {4},
  pages        = {677--687},
  publisher    = {Oxford University Press},
  series       = {Rheumatology (United Kingdom)},
  title        = {Glucocorticoid use and factors associated with variability in this use in the Systemic Lupus International Collaborating Clinics Inception Cohort},
  url          = {http://dx.doi.org/10.1093/rheumatology/kex444},
  volume       = {57},
  year         = {2018},
}