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  • Nguyen, YannCochin Hospital (author)

Association Between Severe Nonadherence to Hydroxychloroquine and Systemic Lupus Erythematosus Flares, Damage, and Mortality in 660 Patients From the SLICC Inception Cohort

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • 2023
  • 12 s.

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:5abe1ce8-efbe-4d45-bf2d-fb72f16334e4
  • https://lup.lub.lu.se/record/5abe1ce8-efbe-4d45-bf2d-fb72f16334e4URI
  • https://doi.org/10.1002/art.42645DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Objective: The goals of this study were to assess the associations of severe nonadherence to hydroxychloroquine (HCQ), objectively assessed by HCQ serum levels, and risks of systemic lupus erythematosus (SLE) flares, damage, and mortality rates over five years of follow-up. Methods: The Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort is an international multicenter initiative (33 centers throughout 11 countries). The serum of patients prescribed HCQ for at least three months at enrollment were analyzed. Severe nonadherence was defined by a serum HCQ level <106 ng/mL or <53 ng/mL for HCQ doses of 400 or 200 mg/day, respectively. Associations with the risk of a flare (defined as a Systemic Lupus Erythematosus Disease Activity Index 2000 increase ≥4 points, initiation of prednisone or immunosuppressive drugs, or new renal involvement) were studied with logistic regression, and associations with damage (first SLICC/American College of Rheumatology Damage Index [SDI] increase ≥1 point) and mortality with separate Cox proportional hazard models. Results: Of the 1,849 cohort participants, 660 patients (88% women) were included. Median (interquartile range) serum HCQ was 388 ng/mL (244–566); 48 patients (7.3%) had severe HCQ nonadherence. No covariates were clearly associated with severe nonadherence, which was, however, independently associated with both flare (odds ratio 3.38; 95% confidence interval [CI] 1.80–6.42) and an increase in the SDI within each of the first three years (hazard ratio [HR] 1.92 at three years; 95% CI 1.05–3.50). Eleven patients died within five years, including 3 with severe nonadherence (crude HR 5.41; 95% CI 1.43–20.39). Conclusion: Severe nonadherence was independently associated with the risks of an SLE flare in the following year, early damage, and five-year mortality. (Figure presented.).

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Blanchet, BenoîtUniversité Paris Cité (author)
  • Urowitz, Murray B.University of Toronto (author)
  • Hanly, John G.Dalhousie University (author)
  • Gordon, CarolineUniversity of Birmingham (author)
  • Bae, Sang CheolHanyang University Hospital for Rheumatic Disease (author)
  • Romero-Diaz, JuanitaSalvador Zubirán National Institute of Health Sciences and Nutrition (author)
  • Sanchez-Guerrero, JorgeMount Sinai Hospital of University of Toronto (author)
  • Clarke, Ann E.Cumming School of Medicine (author)
  • Bernatsky, SashaMcGill University Health Center (author)
  • Wallace, Daniel J.University of California, Los Angeles (author)
  • Isenberg, David A.University College London (author)
  • Rahman, AnisurUniversity College London (author)
  • Merrill, Joan T.Oklahoma Medical Research Foundation (author)
  • Fortin, Paul R.Centre hospitalier universitaire de Québec (author)
  • Gladman, Dafna D.University of Toronto (author)
  • Bruce, Ian N.Manchester Academic Health Science Centre (author)
  • Petri, MichelleJohns Hopkins University School of Medicine (author)
  • Ginzler, Ellen M.SUNY Downstate Health Sciences University (author)
  • Dooley, Mary AnneUniversity of North Carolina (author)
  • Ramsey-Goldman, RosalindNorthwestern University Feinberg School of Medicine (author)
  • Manzi, SusanAllegheny Health Network (author)
  • Jönsen, AndreasLund 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(Swepub:lu)reum-ajo (author)
  • Alarcón, Graciela S.University of Alabama (author)
  • Van Vollenhoven, Ronald F.University of Amsterdam (author)
  • Aranow, CynthiaFeinstein Institute for Medical Research (author)
  • Le Guern, VéroniqueCochin Hospital (author)
  • Mackay, MegganFeinstein Institute for Medical Research (author)
  • Ruiz-Irastorza, GuillermoUniversity of the Basque Country (author)
  • Lim, S. SamEmory University (author)
  • Inanc, MuratIstanbul University (author)
  • Kalunian, Kenneth C.University of California, San Diego (author)
  • Jacobsen, SørenCopenhagen University Hospital (author)
  • Peschken, Christine A.University of Manitoba (author)
  • Kamen, Diane L.Medical University of South Carolina (author)
  • Askanase, AncaIndian Institute of Technology (author)
  • Buyon, JillNYU Grossman School of Medicine (author)
  • Costedoat-Chalumeau, NathalieCochin Hospital (author)
  • Cochin HospitalUniversité Paris Cité (creator_code:org_t)

Related titles

  • In:Arthritis and Rheumatology75:12, s. 2195-22062326-5191

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