Search: onr:"swepub:oai:lup.lub.lu.se:da4fb61c-222b-4600-97ad-59488c39bf44" >
Flares after hydrox...
Flares after hydroxychloroquine reduction or discontinuation : results from the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort
-
- Almeida-Brasil, Celline C. (author)
- McGill University Health Center
-
- Hanly, John G. (author)
- Dalhousie University
-
- Urowitz, Murray (author)
- University of Toronto
-
show more...
-
- Clarke, Ann Elaine (author)
- University of Calgary
-
- Ruiz-Irastorza, Guillermo (author)
- Hospital de Cruces
-
- Gordon, Caroline (author)
- University of Birmingham
-
- Ramsey-Goldman, Rosalind (author)
- Northwestern University
-
- Petri, Michelle (author)
- Johns Hopkins University
-
- Ginzler, Ellen M. (author)
- SUNY Downstate Health Sciences University
-
- Wallace, D. J. (author)
- University of California, Los Angeles
-
- Bae, Sang Cheol (author)
- Hanyang University
-
- Romero-Diaz, Juanita (author)
- Salvador Zubirán National Institute of Health Sciences and Nutrition
-
- Dooley, Mary Anne (author)
- University of North Carolina
-
- Peschken, Christine (author)
- University of Manitoba
-
Isenberg, David (author)
-
- Rahman, Anisur (author)
- University College London
-
- Manzi, Susan (author)
- Allegheny Health Network
-
- Jacobsen, Søren (author)
- Copenhagen University Hospital
-
- Lim, Sam (author)
- Emory University
-
van Vollenhoven, Ronald F. (author)
-
- Nived, Ola (author)
- Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine
-
- Jönsen, Andreas (author)
- Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lund SLE Research Group,Forskargrupper vid Lunds universitet,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups
-
- Kamen, Diane L. (author)
- Medical University of South Carolina
-
Aranow, Cynthia (author)
-
- Sanchez-Guerrero, Jorge (author)
- Toronto Western Hospital
-
- Gladman, Dafna D. (author)
- University of Toronto
-
- Fortin, Paul R. (author)
- Laval University
-
- Alarcón, Graciela S. (author)
- University of Alabama
-
- Merrill, Joan T. (author)
- Oklahoma Medical Research Foundation
-
- Kalunian, Kenneth (author)
- University of California, San Diego
-
- Ramos-Casals, Manuel (author)
- University of Barcelona
-
- Steinsson, Kristján (author)
- National University Hospital of Iceland
-
- Zoma, Asad (author)
- Hairmyres Hospital
-
- Askanase, Anca (author)
- Columbia University
-
- Khamashta, Munther A. (author)
- St Thomas' Hospital
-
- Bruce, Ian N. (author)
- University of Manchester
-
- Inanc, Murat (author)
- Istanbul University
-
- Abrahamowicz, Michal (author)
- McGill University
-
- Bernatsky, Sasha (author)
- McGill University Health Center
-
show less...
-
(creator_code:org_t)
- 2021-12-15
- 2022
- English 9 s.
-
In: Annals of the Rheumatic Diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 81:3, s. 370-378
- Related links:
-
http://dx.doi.org/10... (free)
-
show more...
-
https://ard.bmj.com/...
-
https://lup.lub.lu.s...
-
https://doi.org/10.1...
-
show less...
Abstract
Subject headings
Close
- OBJECTIVES: To evaluate systemic lupus erythematosus (SLE) flares following hydroxychloroquine (HCQ) reduction or discontinuation versus HCQ maintenance. METHODS: We analysed prospective data from the Systemic Lupus International Collaborating Clinics (SLICC) cohort, enrolled from 33 sites within 15 months of SLE diagnosis and followed annually (1999-2019). We evaluated person-time contributed while on the initial HCQ dose ('maintenance'), comparing this with person-time contributed after a first dose reduction, and after a first HCQ discontinuation. We estimated time to first flare, defined as either subsequent need for therapy augmentation, increase of ≥4 points in the SLE Disease Activity Index-2000, or hospitalisation for SLE. We estimated adjusted HRs (aHRs) with 95% CIs associated with reducing/discontinuing HCQ (vs maintenance). We also conducted separate multivariable hazard regressions in each HCQ subcohort to identify factors associated with flare. RESULTS: We studied 1460 (90% female) patients initiating HCQ. aHRs for first SLE flare were 1.20 (95% CI 1.04 to 1.38) and 1.56 (95% CI 1.31 to 1.86) for the HCQ reduction and discontinuation groups, respectively, versus HCQ maintenance. Patients with low educational level were at particular risk of flaring after HCQ discontinuation (aHR 1.43, 95% CI 1.09 to 1.87). Prednisone use at time-zero was associated with over 1.5-fold increase in flare risk in all HCQ subcohorts. CONCLUSIONS: SLE flare risk was higher after HCQ taper/discontinuation versus HCQ maintenance. Decisions to maintain, reduce or stop HCQ may affect specific subgroups differently, including those on prednisone and/or with low education. Further study of special groups (eg, seniors) may be helpful.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
Keyword
- autoimmune diseases
- epidemiology
- hydroxychloroquine
- systemic lupus erythematosus
Publication and Content Type
- art (subject category)
- ref (subject category)
Find in a library
To the university's database
- By the author/editor
-
Almeida-Brasil, ...
-
Hanly, John G.
-
Urowitz, Murray
-
Clarke, Ann Elai ...
-
Ruiz-Irastorza, ...
-
Gordon, Caroline
-
show more...
-
Ramsey-Goldman, ...
-
Petri, Michelle
-
Ginzler, Ellen M ...
-
Wallace, D. J.
-
Bae, Sang Cheol
-
Romero-Diaz, Jua ...
-
Dooley, Mary Ann ...
-
Peschken, Christ ...
-
Isenberg, David
-
Rahman, Anisur
-
Manzi, Susan
-
Jacobsen, Søren
-
Lim, Sam
-
van Vollenhoven, ...
-
Nived, Ola
-
Jönsen, Andreas
-
Kamen, Diane L.
-
Aranow, Cynthia
-
Sanchez-Guerrero ...
-
Gladman, Dafna D ...
-
Fortin, Paul R.
-
Alarcón, Graciel ...
-
Merrill, Joan T.
-
Kalunian, Kennet ...
-
Ramos-Casals, Ma ...
-
Steinsson, Krist ...
-
Zoma, Asad
-
Askanase, Anca
-
Khamashta, Munth ...
-
Bruce, Ian N.
-
Inanc, Murat
-
Abrahamowicz, Mi ...
-
Bernatsky, Sasha
-
show less...
- About the subject
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
-
and Rheumatology and ...
- Articles in the publication
-
Annals of the Rh ...
- By the university
-
Lund University