المؤلفون: Almeida-Brasil, CC, Hanly, JG, Urowitz, M, Clarke, AE, Ruiz-Irastorza, G, Gordon, C, Ramsey-Goldman, R, Petri, M, Ginzler, EM, Wallace, DJ, Bae, S-C, Romero-Diaz, J, Dooley, MA, Peschken, C, Isenberg, D, Rahman, A, Manzi, S, Jacobsen, S, Lim, S, van Vollenhoven, RF, Nived, O, Jönsen, A, Kamen, DL, Aranow, C, Sanchez-Guerrero, J, Gladman, DD, Fortin, PR, Alarcón, GS, Merrill, JT, Kalunian, K, Ramos-Casals, M, Steinsson, K, Zoma, A, Askanase, A, Khamashta, MA, Bruce, IN, Inanc, M, Abrahamowicz, M, Bernatsky, S

المصدر: Annals of the Rheumatic Diseases (2021) (In press).

مصطلحات موضوعية: Autoimmune diseases, epidemiology, hydroxychloroquine, systemic lupus erythematosus

الوصف: 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.

وصف الملف: text

العلاقة: https://discovery.ucl.ac.uk/id/eprint/10140728/1/annrheumdis-2021-221295.full.pdfTest; https://discovery.ucl.ac.uk/id/eprint/10140728Test/

الإتاحة: https://discovery.ucl.ac.uk/id/eprint/10140728/1/annrheumdis-2021-221295.full.pdfTest
https://discovery.ucl.ac.uk/id/eprint/10140728Test/

المؤلفون: Marra, LP, Almeida-Brasil, CC, Guerra-Júnior, AA, Almeida, AM, Lemos, LL

المصدر: Value in Health ; volume 19, issue 3, page A227 ; ISSN 1098-3015

مصطلحات موضوعية: Public Health, Environmental and Occupational Health, Health Policy

الإتاحة: https://doi.org/10.1016/j.jval.2016.03.1171Test
https://api.elsevier.com/content/article/PII:S1098301516012390?httpAccept=text/plainTest
https://api.elsevier.com/content/article/PII:S1098301516012390?httpAccept=text/xmlTest

المؤلفون: Costa, Jd, Almeida-Brasil, CC, Lemos, LL, Gomes, RM, Acurcio, FA, Álvares, J, Guerra Júnior, AA

المصدر: Value in Health ; volume 18, issue 7, page A854 ; ISSN 1098-3015

مصطلحات موضوعية: Public Health, Environmental and Occupational Health, Health Policy

الإتاحة: https://doi.org/10.1016/j.jval.2015.09.451Test
https://api.elsevier.com/content/article/PII:S1098301515025279?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1098301515025279?httpAccept=text/plainTest

المؤلفون: Costa, Jd, Almeida-Brasil, CC, Lemos, LL, Gomes, RM, Acurcio, FA, Álvares, J, Guerra Júnior, AA

المصدر: Value in Health. (7):A854

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=core_ac_uk__::fd5ca78c25eecba78baab40e218dd079Test

المؤلفون: Marra, LP¹, Almeida-Brasil, CC¹, Guerra-Júnior, AA¹, Almeida, AM², Lemos, LL³

المصدر: Value in Health. May2016, Vol. 19 Issue 3, pA227-A227. 1p.

مصطلحات موضوعية: *OSTEOPOROSIS treatment, *TERIPARATIDE, *DRUG efficacy, *MEDICATION safety, *MEDICAL technology, *RANDOMIZED controlled trials, *THERAPEUTICS