Evidence map›Paper›PMID 29765616›Full record

ArticleLupus science & medicine2018

Quantifying the burden of steroid-related damage in SLE in the Hopkins Lupus Cohort.

Julie E Davidson, Qinggong Fu, Sapna Rao, Laurence S Magder, Michelle Petri

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Lupus science & medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01616472 (WEUKBRE5716), which is not on this map. Cited by 24 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 4 pooled it
3.0field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01616472 completednot on this map

WEUKBRE5716: Quantifying the Burden of Steroid-related Damage in Systemic Lupus Erythematosus in the Hopkins Lupus Cohort

TypeobservationalSponsorGlaxoSmithKlineRan2012 to 2016Enrolled1ConditionsSystemic Lupus ErythematosusArmsCumulative corticosteroid exposure
3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 38 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 5 institutions in 3 countries.

Julie E DavidsonReal World Evidence, GlaxoSmithKline R&D, Stockley Park, Uxbridge, UK.ORCID 0000-0003-2185-151X
Qinggong FuReal World Evidence, GlaxoSmithKline R&D, Upper Providence, Pennsylvania, USA.
Sapna RaoReal World Evidence, GlaxoSmithKline R&D, Research Triangle Park, North Carolina, USA.
Laurence S MagderDepartment of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland, USA.
Michelle PetriDivision of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
GlaxoSmithKline (United Kingdom) · GBJohns Hopkins University · USProvidence College · USResearch Triangle Park Foundation · USUniversity of Maryland, Baltimore · US

Funding

Lupus CohortR01AR043727 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI PETRI, MICHELLE A · 1997 to 2015
$8.2M
Hopkins Lupus CohortR01AR069572 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI PETRI, MICHELLE A · 2016 to 2020
$3.4M
NIAMS NIH HHS R01 AR043727NIAMS NIH HHS R01 AR069572
6 · The paper itself

Abstract

objectiveCorticosteroids are a mainstay of SLE treatment; however, cumulative steroid exposure may lead to organ damage. This study aimed to quantify the risk of new diabetes, hypertension, cataracts, osteoporosis and avascular necrosis that is attributable to cumulative corticosteroid exposure in SLE.

methodsUsing data from the Hopkins Lupus Cohort, a longitudinal study of lupus activity, organ damage and quality of life in patients with SLE, five matched case-control analyses nested within a prospectively enrolled SLE cohort were performed. Two randomly selected controls were matched to each case using incidence-density sampling from defined risk sets. Attributable risk was calculated for steroid exposure (dose and duration, separately). Cumulative steroid dose was modelled as a four-level categorical variable using clinically relevant thresholds: 0 g (no exposure); >0 and <3.65 g (<10 mg/day for a year); ≥3.65 g and <18.25 g (1-5 years at 10 mg/day); and ≥18.25 g (>5 years at 10 mg/day).

resultsEligible cases were identified for diabetes (n=42), hypertension (n=79), cataract (n=132), osteoporosis (n=118) and avascular necrosis (n=38). The unadjusted OR for a one-category increase in cumulative steroid exposure ranged from 1.157 (cataract (0.889 to 1.506); p=0.2779) to 2.183 (avascular necrosis (1.162 to 4.103); p=0.0153). After adjusting for confounding variables, a one-category increase in the cumulative steroid dose was significantly associated with risk of cataract (OR (95% CI) 1.855 (1.190 to 2.892); p=0.0064) and osteoporosis (OR (95% CI) 1.604 (1.067 to 2.412); p=0.0232). ORs for avascular necrosis, diabetes and hypertension suggested a moderately increased risk (not significant). Duration of steroid exposure was not associated with any of the outcomes. The proportion of risk attributable to steroid exposure after adjustment for covariates was 0.711 for cataract and 0.540 for osteoporosis.

conclusionsCumulative steroid exposure was associated with an increased risk of cataract and osteoporosis in patients with SLE. TRIAL REGISTRATION NUMBER: NCT01616472.

Indexed as

hopkinsslesteroid

Identifiers

PMID29765616
PMCPMC5950698
OpenAlexW2804689409

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.