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

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 Reategui-Sokolova, Claudia Elera-Fitzcarrald, Cinthia Aranow, Laurent Arnaud, Anca D. Askanase, …
Lupus science & medicine, v 8(1), 000590
01 Dec 2021
DOI: https://doi.org/10.1136/lupus-2021-000590
PMID: 34930819
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1136/lupus-2021-000590View
Published, Version of Record (VoR) Open

Abstract

Life Sciences & Biomedicine Science & Technology Rheumatology
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.

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57 citations in Web of Science
57 citations in Scopus

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Domestic collaboration
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Web of Science research areas
Rheumatology
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