Impact of glucocorticoids on the incidence of lupus-related major organ damage: a systematic literature review and meta-regression analysis of longitudinal observational studies

Manuel Francisco Ugarte-Gil; Anselm Mak; Joanna Leong; Bhushan Dharmadhikari; Nien Yee Kow; Cristina Reátegui-Sokolova; Claudia Elera-Fitzcarrald; Cinthia Aranow; Laurent Arnaud; Anca D Askanase; Sang-Cheol Bae; Sasha Bernatsky; Ian N Bruce; Jill Buyon; Nathalie Costedoat-Chalumeau; Mary Ann Dooley; Paul R Fortin; Ellen M Ginzler; Dafna D Gladman; John Hanly; Murat Inanc; David Isenberg; Soren Jacobsen; Judith A James; Andreas Jönsen; Kenneth Kalunian; Diane L Kamen; Sung Sam Lim; Eric Morand; Marta Mosca; Christine Peschken; Bernardo A Pons-Estel; Anisur Rahman; Rosalind Ramsey-Goldman; John Reynolds; Juanita Romero-Diaz; Guillermo Ruiz-Irastorza; Jorge Sánchez-Guerrero; Elisabet Svenungsson; Murray Urowitz; Evelyne Vinet; Ronald F van Vollenhoven; Alexandre Voskuyl; Daniel J Wallace; Michelle A Petri; Susan Manzi; Ann Elaine Clarke; Mike Cheung; Vernon Farewell; Graciela S Alarcon

doi:10.1136/lupus-2021-000590

Impact of glucocorticoids on the incidence of lupus-related major organ damage: a systematic literature review and meta-regression analysis of longitudinal observational studies

Manuel Francisco Ugarte-Gil, Anselm Mak, Joanna Leong, Bhushan Dharmadhikari, Nien Yee Kow, Cristina Reátegui-Sokolova, Claudia Elera-Fitzcarrald, Cinthia Aranow, Laurent Arnaud, Anca D Askanase, Sang-Cheol Bae, Sasha Bernatsky, Ian N Bruce, Jill Buyon, Nathalie Costedoat-Chalumeau, Mary Ann Dooley, Paul R Fortin, Ellen M Ginzler, Dafna D Gladman, John HanlyMurat Inanc, David Isenberg, Soren Jacobsen, Judith A James, Andreas Jönsen, Kenneth Kalunian, Diane L Kamen, Sung Sam Lim, Eric Morand, Marta Mosca, Christine Peschken, Bernardo A Pons-Estel, Anisur Rahman, Rosalind Ramsey-Goldman, John Reynolds, Juanita Romero-Diaz, Guillermo Ruiz-Irastorza, Jorge Sánchez-Guerrero, Elisabet Svenungsson, Murray Urowitz, Evelyne Vinet, Ronald F van Vollenhoven, Alexandre Voskuyl, Daniel J Wallace, Michelle A Petri, Susan Manzi, Ann Elaine Clarke, Mike Cheung, Vernon Farewell, Graciela S Alarcon

Afdeling for Rygkirurgi, Led- og Bindevævssygdomme HOC

66 Citationer (Scopus)

Abstract

OBJECTIVE: In systemic lupus erythematosus (SLE), disease activity and glucocorticoid (GC) exposure are known to contribute to irreversible organ damage. We aimed to examine the association between GC exposure and organ damage occurrence.

METHODS: We conducted a literature search (PubMed (Medline), Embase and Cochrane January 1966-October 2021). We identified original longitudinal observational studies reporting GC exposure as the proportion of users and/or GC use with dose information as well as the occurrence of new major organ damage as defined in the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Meta-regression analyses were performed. Reviews, case-reports and studies with <5 years of follow-up, <50 patients, different outcomes and special populations were excluded.

RESULTS: We selected 49 articles including 16 224 patients, 14 755 (90.9%) female with a mean age and disease duration of 35.1 years and of 37.1 months. The mean follow-up time was 104.9 months. For individual damage items, the average daily GC dose was associated with the occurrence of overall cardiovascular events and with osteoporosis with fractures. A higher average cumulative dose adjusted (or not)/number of follow-up years and a higher proportion of patients on GC were associated with the occurrence of osteonecrosis.

CONCLUSIONS: We confirm associations of GC use with three specific damage items. In treating patients with SLE, our aim should be to maximise the efficacy of GC and to minimise their harms.

Originalsprog	Engelsk
Artikelnummer	e000590
Tidsskrift	Lupus science & medicine
Vol/bind	8
Udgave nummer	1
ISSN	2053-8790
DOI	https://doi.org/10.1136/lupus-2021-000590
Status	Udgivet - dec. 2021

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Ugarte-Gil, M. F., Mak, A., Leong, J., Dharmadhikari, B., Kow, N. Y., Reátegui-Sokolova, C., Elera-Fitzcarrald, C., Aranow, C., Arnaud, L., Askanase, A. D., Bae, S.-C., Bernatsky, S., Bruce, I. N., Buyon, J., Costedoat-Chalumeau, N., Dooley, M. A., Fortin, P. R., Ginzler, E. M., Gladman, D. D., ... Alarcon, G. S. (2021). Impact of glucocorticoids on the incidence of lupus-related major organ damage: a systematic literature review and meta-regression analysis of longitudinal observational studies. Lupus science & medicine, 8(1), Artikel e000590. https://doi.org/10.1136/lupus-2021-000590

Ugarte-Gil, MF, Mak, A, Leong, J, Dharmadhikari, B, Kow, NY, Reátegui-Sokolova, C, Elera-Fitzcarrald, C, Aranow, C, Arnaud, L, Askanase, AD, Bae, S-C, Bernatsky, S, Bruce, IN, Buyon, J, Costedoat-Chalumeau, N, Dooley, MA, Fortin, PR, Ginzler, EM, Gladman, DD, Hanly, J, Inanc, M, Isenberg, D, Jacobsen, S, James, JA, Jönsen, A, Kalunian, K, Kamen, DL, Lim, SS, Morand, E, Mosca, M, Peschken, C, Pons-Estel, BA, Rahman, A, Ramsey-Goldman, R, Reynolds, J, Romero-Diaz, J, Ruiz-Irastorza, G, Sánchez-Guerrero, J, Svenungsson, E, Urowitz, M, Vinet, E, van Vollenhoven, RF, Voskuyl, A, Wallace, DJ, Petri, MA, Manzi, S, Clarke, AE, Cheung, M, Farewell, V & Alarcon, GS 2021, 'Impact of glucocorticoids on the incidence of lupus-related major organ damage: a systematic literature review and meta-regression analysis of longitudinal observational studies', Lupus science & medicine, bind 8, nr. 1, e000590. https://doi.org/10.1136/lupus-2021-000590

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title = "Impact of glucocorticoids on the incidence of lupus-related major organ damage: a systematic literature review and meta-regression analysis of longitudinal observational studies",

abstract = "OBJECTIVE: In systemic lupus erythematosus (SLE), disease activity and glucocorticoid (GC) exposure are known to contribute to irreversible organ damage. We aimed to examine the association between GC exposure and organ damage occurrence.METHODS: We conducted a literature search (PubMed (Medline), Embase and Cochrane January 1966-October 2021). We identified original longitudinal observational studies reporting GC exposure as the proportion of users and/or GC use with dose information as well as the occurrence of new major organ damage as defined in the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Meta-regression analyses were performed. Reviews, case-reports and studies with <5 years of follow-up, <50 patients, different outcomes and special populations were excluded.RESULTS: We selected 49 articles including 16 224 patients, 14 755 (90.9\%) female with a mean age and disease duration of 35.1 years and of 37.1 months. The mean follow-up time was 104.9 months. For individual damage items, the average daily GC dose was associated with the occurrence of overall cardiovascular events and with osteoporosis with fractures. A higher average cumulative dose adjusted (or not)/number of follow-up years and a higher proportion of patients on GC were associated with the occurrence of osteonecrosis.CONCLUSIONS: We confirm associations of GC use with three specific damage items. In treating patients with SLE, our aim should be to maximise the efficacy of GC and to minimise their harms.",

author = "Ugarte-Gil, \{Manuel Francisco\} and Anselm Mak and Joanna Leong and Bhushan Dharmadhikari and Kow, \{Nien Yee\} and Cristina Re{\'a}tegui-Sokolova and Claudia Elera-Fitzcarrald and Cinthia Aranow and Laurent Arnaud and Askanase, \{Anca D\} and Sang-Cheol Bae and Sasha Bernatsky and Bruce, \{Ian N\} and Jill Buyon and Nathalie Costedoat-Chalumeau and Dooley, \{Mary Ann\} and Fortin, \{Paul R\} and Ginzler, \{Ellen M\} and Gladman, \{Dafna D\} and John Hanly and Murat Inanc and David Isenberg and Soren Jacobsen and James, \{Judith A\} and Andreas J{\"o}nsen and Kenneth Kalunian and Kamen, \{Diane L\} and Lim, \{Sung Sam\} and Eric Morand and Marta Mosca and Christine Peschken and Pons-Estel, \{Bernardo A\} and Anisur Rahman and Rosalind Ramsey-Goldman and John Reynolds and Juanita Romero-Diaz and Guillermo Ruiz-Irastorza and Jorge S{\'a}nchez-Guerrero and Elisabet Svenungsson and Murray Urowitz and Evelyne Vinet and \{van Vollenhoven\}, \{Ronald F\} and Alexandre Voskuyl and Wallace, \{Daniel J\} and Petri, \{Michelle A\} and Susan Manzi and Clarke, \{Ann Elaine\} and Mike Cheung and Vernon Farewell and Alarcon, \{Graciela S\}",

note = "{\textcopyright} Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2021",

month = dec,

doi = "10.1136/lupus-2021-000590",

language = "English",

volume = "8",

journal = "Lupus science \& medicine",

issn = "2053-8790",

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TY - JOUR

T1 - Impact of glucocorticoids on the incidence of lupus-related major organ damage

T2 - a systematic literature review and meta-regression analysis of longitudinal observational studies

AU - Ugarte-Gil, Manuel Francisco

AU - Mak, Anselm

AU - Leong, Joanna

AU - Dharmadhikari, Bhushan

AU - Kow, Nien Yee

AU - Reátegui-Sokolova, Cristina

AU - Elera-Fitzcarrald, Claudia

AU - Aranow, Cinthia

AU - Arnaud, Laurent

AU - Askanase, Anca D

AU - Bae, Sang-Cheol

AU - Bernatsky, Sasha

AU - Bruce, Ian N

AU - Buyon, Jill

AU - Costedoat-Chalumeau, Nathalie

AU - Dooley, Mary Ann

AU - Fortin, Paul R

AU - Ginzler, Ellen M

AU - Gladman, Dafna D

AU - Hanly, John

AU - Inanc, Murat

AU - Isenberg, David

AU - Jacobsen, Soren

AU - James, Judith A

AU - Jönsen, Andreas

AU - Kalunian, Kenneth

AU - Kamen, Diane L

AU - Lim, Sung Sam

AU - Morand, Eric

AU - Mosca, Marta

AU - Peschken, Christine

AU - Pons-Estel, Bernardo A

AU - Rahman, Anisur

AU - Ramsey-Goldman, Rosalind

AU - Reynolds, John

AU - Romero-Diaz, Juanita

AU - Ruiz-Irastorza, Guillermo

AU - Sánchez-Guerrero, Jorge

AU - Svenungsson, Elisabet

AU - Urowitz, Murray

AU - Vinet, Evelyne

AU - van Vollenhoven, Ronald F

AU - Voskuyl, Alexandre

AU - Wallace, Daniel J

AU - Petri, Michelle A

AU - Manzi, Susan

AU - Clarke, Ann Elaine

AU - Cheung, Mike

AU - Farewell, Vernon

AU - Alarcon, Graciela S

PY - 2021/12

Y1 - 2021/12

N2 - OBJECTIVE: In systemic lupus erythematosus (SLE), disease activity and glucocorticoid (GC) exposure are known to contribute to irreversible organ damage. We aimed to examine the association between GC exposure and organ damage occurrence.METHODS: We conducted a literature search (PubMed (Medline), Embase and Cochrane January 1966-October 2021). We identified original longitudinal observational studies reporting GC exposure as the proportion of users and/or GC use with dose information as well as the occurrence of new major organ damage as defined in the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Meta-regression analyses were performed. Reviews, case-reports and studies with <5 years of follow-up, <50 patients, different outcomes and special populations were excluded.RESULTS: We selected 49 articles including 16 224 patients, 14 755 (90.9%) female with a mean age and disease duration of 35.1 years and of 37.1 months. The mean follow-up time was 104.9 months. For individual damage items, the average daily GC dose was associated with the occurrence of overall cardiovascular events and with osteoporosis with fractures. A higher average cumulative dose adjusted (or not)/number of follow-up years and a higher proportion of patients on GC were associated with the occurrence of osteonecrosis.CONCLUSIONS: We confirm associations of GC use with three specific damage items. In treating patients with SLE, our aim should be to maximise the efficacy of GC and to minimise their harms.

AB - OBJECTIVE: In systemic lupus erythematosus (SLE), disease activity and glucocorticoid (GC) exposure are known to contribute to irreversible organ damage. We aimed to examine the association between GC exposure and organ damage occurrence.METHODS: We conducted a literature search (PubMed (Medline), Embase and Cochrane January 1966-October 2021). We identified original longitudinal observational studies reporting GC exposure as the proportion of users and/or GC use with dose information as well as the occurrence of new major organ damage as defined in the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Meta-regression analyses were performed. Reviews, case-reports and studies with <5 years of follow-up, <50 patients, different outcomes and special populations were excluded.RESULTS: We selected 49 articles including 16 224 patients, 14 755 (90.9%) female with a mean age and disease duration of 35.1 years and of 37.1 months. The mean follow-up time was 104.9 months. For individual damage items, the average daily GC dose was associated with the occurrence of overall cardiovascular events and with osteoporosis with fractures. A higher average cumulative dose adjusted (or not)/number of follow-up years and a higher proportion of patients on GC were associated with the occurrence of osteonecrosis.CONCLUSIONS: We confirm associations of GC use with three specific damage items. In treating patients with SLE, our aim should be to maximise the efficacy of GC and to minimise their harms.

UR - https://www.scopus.com/pages/publications/85122251038

U2 - 10.1136/lupus-2021-000590

DO - 10.1136/lupus-2021-000590

M3 - Review

C2 - 34930819

SN - 2053-8790

VL - 8

JO - Lupus science & medicine

JF - Lupus science & medicine

IS - 1

M1 - e000590

ER -

Impact of glucocorticoids on the incidence of lupus-related major organ damage: a systematic literature review and meta-regression analysis of longitudinal observational studies

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