Factors predictive of serious infections over time in systemic lupus erythematosus patients: data from a multi-ethnic, multi-national, Latin American lupus cohort

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dc.contributor.authorPimentel-Quiroz, Víctor
dc.contributor.authorUgarte-Gil, M.F.
dc.contributor.authorHarvey, G.B.
dc.contributor.authorWojdyla, D.
dc.contributor.authorPons-Estel, G.J.
dc.contributor.authorQuintana, R.
dc.contributor.authorEsposto, A.
dc.contributor.authorGarcía, M.A.
dc.contributor.authorCatoggio, L.J.
dc.contributor.authorCardiel, M.H.
dc.contributor.authorBarile, L.A.
dc.contributor.authorAmigo, M-C.
dc.contributor.authorSato, E. I.
dc.contributor.authorBonfa, E.
dc.contributor.authorBorba, E.
dc.contributor.authorLavras Costallat, L T.
dc.contributor.authorNeira, Oscar
dc.contributor.authorMassardo, L.
dc.contributor.authorGuibert-Toledano, M.
dc.contributor.authorChacón-Díaz, R.
dc.contributor.authorAlarcón, G.S.
dc.contributor.authorPons-Estel, B. A.
dc.date.accessioned2022-07-21T19:58:46Z
dc.date.available2022-07-21T19:58:46Z
dc.date.issued2019
dc.description.abstractAim: The aim of this study was to identify factors predictive of serious infections over time in patients with systemic lupus erythematosus (SLE). Methods: A multi-ethnic, multi-national Latin American SLE cohort was studied. Serious infection was defined as one that required hospitalization, occurred during a hospitalization or led to death. Potential predictors included were sociodemographic factors, clinical manifestations (per organ involved, lymphopenia and leukopenia, independently) and previous infections at baseline. Disease activity (SLEDAI), damage (SLICC/ACR Damage Index), non-serious infections, glucocorticoids, antimalarials (users and non-users), and immunosuppressive drugs use; the last six variables were examined as time-dependent covariates. Cox regression models were used to evaluate the predictors of serious infections using a backward elimination procedure. Univariable and multivariable analyses were performed. Results: Of the 1243 patients included, 1116 (89.8%) were female. The median (interquartile range) age at diagnosis and follow-up time were 27 (20-37) years and 47.8 (17.9-68.6) months, respectively. The incidence rate of serious infections was 3.8 cases per 100 person-years. Antimalarial use (hazard ratio: 0.69; 95% confidence interval (CI): 0.48-0.99; p = 0.0440) was protective, while doses of prednisone >15 and ≤60 mg/day (hazard ratio: 4.18; 95 %CI: 1.69-10.31; p = 0.0019) and >60 mg/day (hazard ratio: 4.71; 95% CI: 1.35-16.49; p = 0.0153), use of methylprednisolone pulses (hazard ratio: 1.53; 95% CI: 1.10-2.13; p = 0.0124), increase in disease activity (hazard ratio: 1.03; 95% CI: 1.01-1.04; p = 0.0016) and damage accrual (hazard ratio: 1.22; 95% CI: 1.11-1.34; p < 0.0001) were predictive factors of serious infections. Conclusions: Over time, prednisone doses higher than 15 mg/day, use of methylprednisolone pulses, increase in disease activity and damage accrual were predictive of infections, whereas antimalarial use was protective against them in SLE patients.es
dc.description.versionVersión Publicadaes
dc.identifier.citationPimentel-Quiroz VR, Ugarte-Gil MF, Harvey GB, Wojdyla D, Pons-Estel GJ, Quintana R, Esposto A, García MA, Catoggio LJ, Cardiel MH, Barile LA, Amigo MC, Sato EI, Bonfa E, Borba E, Lavras Costallat LT, Neira OJ, Massardo L, Guibert-Toledano M, Chacón-Díaz R, Alarcón GS, Pons-Estel BA. Factors predictive of serious infections over time in systemic lupus erythematosus patients: data from a multi-ethnic, multi-national, Latin American lupus cohort. Lupus. 2019 Aug;28(9):1101-1110. doi: 10.1177/0961203319860579.es
dc.identifier.urihttp://doi.org/10.1177/0961203319860579.es
dc.identifier.urihttp://hdl.handle.net/11447/6380
dc.language.isoenes
dc.subjectSystemic lupus erythematosuses
dc.subjectAntimalarial usees
dc.subjectGlucocorticoid usees
dc.subjectSerious infectionses
dc.titleFactors predictive of serious infections over time in systemic lupus erythematosus patients: data from a multi-ethnic, multi-national, Latin American lupus cohortes
dc.typeArticlees
dcterms.sourceLupuses

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