Journal article
Glucocorticoid use and factors associated with variability in this use in the Systemic Lupus International Collaborating Clinics Inception Cohort
Rheumatology (Oxford, England), v 57(4), pp 677-687
01 Apr 2018
PMID: 29361147
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Abstract
Objectives
To describe glucocorticoid (GC) use in the SLICC inception cohort and to explore factors associated with GC use. In particular we aimed to assess temporal trends in GC use and to what extent physician-related factors may influence use.
Methods
Patients were recruited within 15 months of diagnosis of SLE from 33 centres between 1999 and 2011 and continue to be reviewed annually. Descriptive statistics were used to detail oral and parenteral GC use. Cross sectional and longitudinal analyses were performed to explore factors associated with GC use at enrolment and over time.
Results
We studied 1700 patients with a mean (s.d.) follow-up duration of 7.26 (3.82) years. Over the entire study period, 1365 (81.3%) patients received oral GCs and 447 (26.3%) received parenteral GCs at some point. GC use was strongly associated with treatment centre, age, race/ethnicity, sex, disease duration and disease activity. There was no change in the proportion of patients on GCs or the average doses of GC used over time according to year of diagnosis.
Conclusion
GCs remain a cornerstone in SLE management and there have been no significant changes in their use over the past 10-15 years. While patient and disease factors contribute to the variation in GC use, between-centre differences suggest that physician-related factors also contribute. Evidence-based treatment algorithms are needed to inform a more standardized approach to GC use in SLE.
Metrics
Details
- Title
- Glucocorticoid use and factors associated with variability in this use in the Systemic Lupus International Collaborating Clinics Inception Cohort
- Creators
- Jayne Little - Versus ArthritisBen Parker - Manchester Academic Health Science CentreMark Lunt - University of ManchesterJohn G Hanly - Queen Elizabeth II Health Sciences CentreMurray B Urowitz - Toronto Western HospitalAnn E Clarke - University of CalgaryJuanita Romero-Diaz - Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránCaroline Gordon - University of BirminghamSang-Cheol Bae - Hanyang University Seoul HospitalSasha Bernatsky - McGill University Health CentreDaniel J Wallace - Cedars-Sinai Medical CenterJoan T Merrill - Oklahoma Medical Research FoundationJill Buyon - New York UniversityDavid A Isenberg - University College LondonAnisur Rahman - University College LondonEllen M Ginzler - SUNY Downstate Health Sciences UniversityMichelle Petri - Johns Hopkins MedicineMary Anne Dooley - University of North Carolina at Chapel HillPaul Fortin - Université LavalDafna D Gladman - Toronto Western HospitalKristjan Steinsson - Reykjavík UniversityRosalind Ramsey-Goldman - Northwestern UniversityMunther A Khamashta - St Thomas' HospitalCynthia Aranow - Feinstein Institute for Medical ResearchMeggan Mackay - Feinstein Institute for Medical ResearchGraciela S Alarcón - University of Alabama at BirminghamSusan Manzi - Allegheny Health NetworkOla Nived - Lund UniversityAndreas Jönsen - Lund UniversityAsad A Zoma - Hairmyres HospitalRonald F van Vollenhoven - Karolinska InstitutetManuel Ramos-Casals - Consorci Institut D'Investigacions Biomediques August Pi I SunyerGuillermo Ruiz-Irastorza - University of the Basque CountrySung Sam Lim - Emory University School of MedicineKenneth C Kalunian - University of California, San DiegoMurat Inanc - Istanbul UniversityDiane L Kamen - Medical University of South CarolinaChristine A Peschken - University of ManitobaSoren Jacobsen - Copenhagen University HospitalAnca Askanase - New York University Langone Orthopedic HospitalJorge Sanchez-Guerrero - Mount Sinai HospitalIan N Bruce - Versus Arthritis
- Publication Details
- Rheumatology (Oxford, England), v 57(4), pp 677-687
- Publisher
- Oxford University Press
- Number of pages
- 11
- Grant note
- MOP-88526 / Canadian Institutes of Health Research (10.13039/501100000024) Wellcome Trust (10.13039/100004440) 8UL1TR000150; UL-1RR-025741; K24-AR-02318; P60AR064464; P60-AR-48098; RR00046 / NIH (10.13039/100000002) 20164 / Arthritis Research UK (10.13039/501100000341) National Institute for Health Research (10.13039/501100000272) National Institute for Health Research University College London Hospitals Biomedical Research Centre A1028 / Danish Rheumatism Association (10.13039/100008368) NIHR (10.13039/100006662) AR43727 / NIH (10.13039/100000002) 201600000001387 / Hanyang University (10.13039/501100002380)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000428874200015
- Scopus ID
- 2-s2.0-85045074075
- Other Identifier
- 991021933899704721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Rheumatology