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EVALUATING GLOBAL PATTERNS IN TREATMENT AND PREVALENCE OF COMORBIDITIES IN SYSTEMIC LUPUS ERYTHEMATOSUS

Holloway, A. (författare)
Kings College Hospital, Rheumatology Department, London, United Kingdom
Lee, S. Y. (författare)
Kings College Hospital, Rheumatology Department, London, United Kingdom
Nikiphorou, E. (författare)
Kings College Hospital, Rheumatology Department, London, United Kingdom; Kings College Hospital, Rheumatology Department, London, United Kingdom
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Parodis, Ioannis, 1981- (författare)
Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Faculty of Medicine and Health, Örebro University, Department of Rheumatology, Örebro, Sweden; Karolinska Institutet and Karolinska University Hospital, Division of Rheumatology, Department of Medicine Solna, Stockholm, Sweden
Ravichandran, N. (författare)
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Clinical Immunology and Rheumatology, Lucknow, India
Day, J. (författare)
The Royal Melbourne Hospital, Department of Rheumatology, Parkville, Australia; WEHI - Walter and Eliza Hall Institute of Medical Research, Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; University of Melbourne, Department of Medical Biology, Parkville, Australia
Joshi, M. (författare)
Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India
Saha, S. (författare)
Mymensingh Medical College, Mymensingh, Bangladesh
Shaharir, S. S. (författare)
Universiti Kebangsaan Malaysia, Faculty of Medicine, Bangi, Malaysia
Katchamart, W. (författare)
Faculty of Medicine Siriraj Hospital, Mahidol University, Division of Rheumatology, Department of Medicine, Bangkok, Thailand
Goo, P. A. (författare)
Queen Savang Vadhana Memorial Hospital, Department of Medicine, Chonburi, Thailand
Traboco, L. (författare)
St. Luke’s Medical Center - Global City, Department of Medicine, Section of Rheumatology, Taguig, Philippines
Chen, Y. M. (författare)
Taichung Veterans General Hospital, Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung City, Taiwan, Republic of China; Taichung Veterans General Hospital, Department of Medical Research, Taichung, Taiwan, Republic of China
Sen, P. (författare)
Maulana Azad Medical College (MAMC), New Delhi, India
Lilleker, J. B. (författare)
The University of Manchester, Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Manchester, United Kingdom; Salford Royal NHS Foundation Trust, Manchester Centre for Clinical Neurosciences, Manchester, United Kingdom
Nune, A. (författare)
Southport & Ormskirk Hospital NHS Trust, Southport, United Kingdom
Pauling, J. (författare)
University of Bristol, Bristol Medical School Translational Health Sciences, Bristol, United Kingdom; North Bristol NHS Trust, Department of Rheumatology, Bristol, United Kingdom
Tan, A. L. (författare)
Leeds Teaching Hospitals NHS Trust, NIHR Leeds Biomedical Research Centre, Leeds, United Kingdom; University of Leeds, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, United Kingdom
Ziade, N. (författare)
Saint Joseph University of Beirut, Rheumatology Department, Beirut, Lebanon; Hôtel-Dieu de France Hospital, Rheumatology Department, Beirut, Lebanon
Milchert, M. (författare)
Pomeranian Medical University, Department of Internal Medicine, Rheumatology, Diabetology, Geriatrics and Clinical Immunology, Szczecin, Poland
Gracia-Ramos, A. E. (författare)
General HospitalNational Medical Center “La Raza”, Instituto Mexicano del Seguro Social, Department of Internal Medicine, Mexico City, Mexico
Vinicio Caballero, C. (författare)
Hospital Universidad del Norte, Department of Medicine, Barranquilla, Colombia
Agarwal, V. (författare)
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Clinical Immunology and Rheumatology, Lucknow, India
Aggarwal, R. (författare)
University of Pittsburgh School of Medicine, Division of Rheumatology and Clinical Immunology, Pittsburgh, United States of America
Gupta, L. (författare)
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Clinical Immunology and Rheumatology, Lucknow, India; The University of Manchester, Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Manchester, United Kingdom; Royal Wolverhampton Hospitals NHS Trust, Department of Rheumatology, Wolverhampton, United Kingdom; City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Department of Rheumatology, Birmingham, United Kingdom
Wincup, C. (författare)
Kings College Hospital, Rheumatology Department, London, United Kingdom; Kings College Hospital, Rheumatology Department, London, United Kingdom
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 (creator_code:org_t)
HighWire Press, 2023
2023
Engelska.
Ingår i: Annals of the Rheumatic Diseases. - : HighWire Press. - 0003-4967 .- 1468-2060. ; 82:Suppl. 1, s. 1456-1458
Relaterad länk:
https://doi.org/10.1...
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https://urn.kb.se/re...
https://doi.org/10.1...
http://kipublication...
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  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
Abstract Ämnesord
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  • Background: Regional disparities in the management of systemic lupus erythematosus (SLE) are frequently described. Governance, funding, logistic barriers, and physician choice may be important determinants though scarce data from underrepresented regions limits our understanding.Objectives: To evaluate global patterns in treatment of SLE and identify the prevalence of comorbidities.Methods: We identified SLE patients from the COVAD 2 database, consisting of over 20,000 respondents worldwide. Healthy controls (HC) were included to assess population comorbidity levels. Demographics, treatment i.e., corticosteroids (CS), antimalarials, immunosuppressants (IS), cyclophosphamide and biologics plus comorbidity data was recorded. Country Human Development Index (HDI) classification, a composite index formulated by the United Nations to rank countries into tiers of development, was utilised.Results: 3323 HCs and 1167 SLE patients were included in analysis. Patients from low/medium HDI (lmHDI) countries were younger than those from high/very high HDI (hvhHDI) countries (median age 32, IQR 27-41 vs 41, IQR 32-52 years, p<0.0001). Disease duration was shorter in lmHDI countries (median 5, IQR 3-10 vs 10, IQR 5-19 years, p<0.0001).A higher proportion of SLE patients from lmHDI countries were on CS (73% vs 59%, p=0.0002), antimalarials (81% vs 68%, p=0.0002) and IS (66% vs 53%, p=0.0009) compared with patients from hvhHDI countries. Choice of IS varied with azathioprine prescribed more frequently in lmHDI countries (p=0.049). Biologics use was more common in hvhHDI countries (7% vs 2%, p=0.0055). Comorbidity prevalence was similar between groups, however when adjusted for age, patients with chronic kidney disease were significantly younger in lmHDI countries (36.67 vs 44.64 years, p=0.015), as were patients with coronary artery disease (35.7 vs. 44.6 years, p=0.015) and hypertension (41.5 vs 49.8 years, p=0.003). Results are detailed in Table 1.Conclusion: To our knowledge, this is the largest study evaluating treatment and comorbidity incidence in SLE populations based on country HDI. We identified striking differences in pharmacological management globally. Cardiovascular comorbidities were seen in younger patients and earlier in the disease course in lmHDI countries, suggestive of premature organ damage. This could be due to limited global access to high-cost medication and increasing access may improve outcomes. Our results call for review of cardiovascular risk guidelines and regional approaches to preventive action as well as pharmacological and non-pharmacological management of patients with established cardiovascular comorbidity.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)

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