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Association Between...
Association Between Severe Nonadherence to Hydroxychloroquine and Systemic Lupus Erythematosus Flares, Damage, and Mortality in 660 Patients From the SLICC Inception Cohort
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- Nguyen, Yann (author)
- Cochin Hospital
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- Blanchet, Benoît (author)
- Université Paris Cité
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- Urowitz, Murray B. (author)
- University of Toronto
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- Hanly, John G. (author)
- Dalhousie University
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- Gordon, Caroline (author)
- University of Birmingham
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- Bae, Sang Cheol (author)
- Hanyang University Hospital for Rheumatic Disease
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- Romero-Diaz, Juanita (author)
- Salvador Zubirán National Institute of Health Sciences and Nutrition
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- Sanchez-Guerrero, Jorge (author)
- Mount Sinai Hospital of University of Toronto
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- Clarke, Ann E. (author)
- Cumming School of Medicine
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- Bernatsky, Sasha (author)
- McGill University Health Center
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- Wallace, Daniel J. (author)
- University of California, Los Angeles
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- Isenberg, David A. (author)
- University College London
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- Rahman, Anisur (author)
- University College London
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- Merrill, Joan T. (author)
- Oklahoma Medical Research Foundation
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- Fortin, Paul R. (author)
- Centre hospitalier universitaire de Québec
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- Gladman, Dafna D. (author)
- University of Toronto
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- Bruce, Ian N. (author)
- Manchester Academic Health Science Centre
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- Petri, Michelle (author)
- Johns Hopkins University School of Medicine
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- Ginzler, Ellen M. (author)
- SUNY Downstate Health Sciences University
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- Dooley, Mary Anne (author)
- University of North Carolina
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- Ramsey-Goldman, Rosalind (author)
- Northwestern University Feinberg School of Medicine
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- Manzi, Susan (author)
- Allegheny Health Network
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- 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
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- Alarcón, Graciela S. (author)
- University of Alabama
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- Van Vollenhoven, Ronald F. (author)
- University of Amsterdam
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- Aranow, Cynthia (author)
- Feinstein Institute for Medical Research
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- Le Guern, Véronique (author)
- Cochin Hospital
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- Mackay, Meggan (author)
- Feinstein Institute for Medical Research
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- Ruiz-Irastorza, Guillermo (author)
- University of the Basque Country
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- Lim, S. Sam (author)
- Emory University
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- Inanc, Murat (author)
- Istanbul University
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- Kalunian, Kenneth C. (author)
- University of California, San Diego
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- Jacobsen, Søren (author)
- Copenhagen University Hospital
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- Peschken, Christine A. (author)
- University of Manitoba
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- Kamen, Diane L. (author)
- Medical University of South Carolina
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- Askanase, Anca (author)
- Indian Institute of Technology
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- Buyon, Jill (author)
- NYU Grossman School of Medicine
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- Costedoat-Chalumeau, Nathalie (author)
- Cochin Hospital
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(creator_code:org_t)
- 2023
- 2023
- English 12 s.
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In: Arthritis and Rheumatology. - 2326-5191. ; 75:12, s. 2195-2206
- Related links:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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Abstract
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- 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
- 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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- art (subject category)
- ref (subject category)
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Nguyen, Yann
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Blanchet, Benoît
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Urowitz, Murray ...
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Hanly, John G.
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Gordon, Caroline
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Bae, Sang Cheol
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Romero-Diaz, Jua ...
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Sanchez-Guerrero ...
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Clarke, Ann E.
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Bernatsky, Sasha
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Wallace, Daniel ...
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Isenberg, David ...
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Rahman, Anisur
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Merrill, Joan T.
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Fortin, Paul R.
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Gladman, Dafna D ...
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Bruce, Ian N.
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Petri, Michelle
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Ginzler, Ellen M ...
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Dooley, Mary Ann ...
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Ramsey-Goldman, ...
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Manzi, Susan
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Jönsen, Andreas
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Alarcón, Graciel ...
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Van Vollenhoven, ...
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Aranow, Cynthia
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Le Guern, Véroni ...
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Mackay, Meggan
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Ruiz-Irastorza, ...
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Lim, S. Sam
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Inanc, Murat
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Kalunian, Kennet ...
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Jacobsen, Søren
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Peschken, Christ ...
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Kamen, Diane L.
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Askanase, Anca
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Buyon, Jill
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Costedoat-Chalum ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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Arthritis and Rh ...
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Lund University