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

V. R. Pimentel-Quiroz, M. F. Ugarte-Gil, G. B. Harvey, D. Wojdyla, G. J. Pons-Estel, R. Quintana, A. Esposto, M. A. García, L. J. Catoggio, M. H. Cardiel, L. A. Barile, M. C. Amigo, E. I. Sato, E. Bonfa, E. Borba, L. T. Lavras Costallat, O. J. Neira, L. Massardo, M. Guibert-Toledano, R. Chacón-DíazG. S. Alarcón, B. A. Pons-Estel

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

© The Author(s) 2019. Aim: 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.
Original languageAmerican English
Pages (from-to)1101-1110
Number of pages10
JournalLupus
DOIs
StatePublished - 1 Aug 2019
Externally publishedYes

Fingerprint Dive into the research topics of 'Factors predictive of serious infections over time in systemic lupus erythematosus patients: data from a multi-ethnic, multi-national, Latin American lupus cohort'. Together they form a unique fingerprint.

  • Cite this

    Pimentel-Quiroz, V. R., Ugarte-Gil, M. F., Harvey, G. B., Wojdyla, D., Pons-Estel, G. J., Quintana, R., Esposto, A., García, M. A., Catoggio, L. J., Cardiel, M. H., Barile, L. A., Amigo, M. C., Sato, E. I., Bonfa, E., Borba, E., Lavras Costallat, L. T., Neira, O. J., Massardo, L., Guibert-Toledano, M., ... Pons-Estel, B. A. (2019). Factors predictive of serious infections over time in systemic lupus erythematosus patients: data from a multi-ethnic, multi-national, Latin American lupus cohort. Lupus, 1101-1110. https://doi.org/10.1177/0961203319860579