Evidence map›Paper›PMID 32653901›Full record

ArticleRheumatology (Oxford, England)2021

Mortality, causes of death and influence of medication use in patients with systemic lupus erythematosus vs matched controls.

Irene E M Bultink, Frank de Vries, Ronald F van Vollenhoven, Arief Lalmohamed

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Rheumatology (Oxford, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 3 pooled it
9.3field-weighted citation impact, top 1% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 3 syntheses or guidelines pooled it, 86 citations in OpenAlex.

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  10. Review of Promising Off-Label Use of Deucravacitinib.International journal of molecular sciences · 2025
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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

4 authors at 2 institutions in 2 countries.

Irene E M BultinkDepartment of Rheumatology, Amsterdam Rheumatology and immunology Center, VU University Medical Center, Amsterdam.
Frank de VriesDivision of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht.
Ronald F van VollenhovenDepartment of Rheumatology, Amsterdam Rheumatology and immunology Center, VU University Medical Center, Amsterdam.
Arief LalmohamedDivision of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht.
University Medical Center · USUtrecht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesWe wanted to estimate the magnitude of the risk from all-cause, cause-specific and sex-specific mortality in patients with SLE and relative risks compared with matched controls and to evaluate the influence of exposure to medication on risk of mortality in SLE.

methodsWe conducted a population-based cohort study using the Clinical Practice Research Datalink, Hospital Episode Statistics and national death certificates (from 1987 to 2012). Each SLE patient (n = 4343) was matched with up to six controls (n = 21 780) by age and sex. Cox proportional hazards models were used to estimate overall and cause-specific mortality rate ratios.

resultsPatients with SLE had a 1.8-fold increased mortality rate for all-cause mortality compared with age- and sex-matched subjects [adjusted hazard ratio (HR) = 1.80, 95% CI: 1.57, 2.08]. The HR was highest in patients aged 18-39 years (adjusted HR = 4.87, 95% CI: 1.93, 12.3). Mortality rates were not significantly different between male and female patients. Cumulative glucocorticoid use raised the mortality rate, whereas the HR was reduced by 45% with cumulative low-dose HCQ use. Patients with SLE had increased cause-specific mortality rates for cardiovascular disease, infections, non-infectious respiratory disease and for death attributable to accidents or suicide, whereas the mortality rate for cancer was reduced in comparison to controls.

conclusionBritish patients with SLE had a 1.8-fold increased mortality rate compared with the general population. Glucocorticoid use and being diagnosed at a younger age were associated with an increased risk of mortality. HCQ use significantly reduced the mortality rate, but this association was found only in the lowest cumulative dosage exposure group.

Indexed as

AdolescentAdultAgedAged, 80 and overAge DistributionCardiovascular DiseasesCase-Control StudiesCause of DeathConfidence IntervalsConfounding Factors, EpidemiologicFemaleFollow-Up StudiesGlucocorticoidsHumansLupus Erythematosus, SystemicMaleGlucocorticoidscause of deathglucocorticosteroidshydroxychloroquinemortalitysystemic lupus erythematosustreatment

Identifiers

PMID32653901
PMCPMC8312724
OpenAlexW3041234419

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

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.