ArticleRheumatology (Oxford, England)2024
Glucocorticoid treatment in SLE is associated with infections, comorbidities and mortality-a national cohort study.
Article in Rheumatology (Oxford, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Prevalence, incidence, and risk factors for herpes zoster in systemic lupus erythematosus: a systematic review and meta-analysis.Frontiers in immunology · 2025Pooled it
- Effects ofNarra J · 2024Trial
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- Early SLE may follow a fast comorbidity/multimorbidity trajectory associated with flare burden and glucocorticoid exposure.RMD open · 2026Article
- Real-World Effectiveness and Safety of Anifrolumab in Egyptian Patients with Moderate-to-Severe Systemic Lupus Erythematosus: A Retrospective Multicenter Study.Journal of clinical medicine · 2026Article
- Prospective Quantification of Glucocorticoid Toxicity Across Dosage Ranges in Systemic Lupus Erythematosus: Insights from the Glucocorticoid Toxicity Index.Rheumatology and therapy · 2026Article
- Efficacy and safety of belimumab in lupus nephritis: a real-world retrospective observational study stratified by treatment phase and age.Clinical rheumatology · 2026Observational
- Revisiting lupus low disease activity: validation matters, but vindication is imperative.Rheumatology (Oxford, England) · 2026Article
- Article
- Association between disease duration and comorbidity burden in systemic lupus erythematosus: a multicentre study from Pakistan.Lupus science & medicine · 2025Article
- Burden of herpes zoster among patients with systemic lupus erythematosus in the USA.Lupus science & medicine · 2025Article
- Article
- Advances in the treatment of systemic lupus erythematosus.Nature reviews. Drug discovery · 2025Review
- Nipocalimab, an immunoselective FcRn blocker that lowers IgG and has unique molecular properties.mAbs · 2025Article
- Observational
- Treat-To-Target: Emergence of Second-Generation CD40L Inhibitors for Treatment of SLE-Identifying Beneficial Patient Candidates for CD40L Inhibitors in a Cross-Sectional SLE Cohort.Scandinavian journal of immunology · 2025Article
- Clinical Outcomes of Patients with SLE Treated with Belimumab, Without Versus With Prior Immunosuppressant Use: a US Claims Database Study.Rheumatology and therapy · 2025Article
- Temporal trends in glucocorticoids and hydroxychloroquine for treatment of systemic lupus erythematosus in Sweden.Rheumatology (Oxford, England) · 2025Article
- Urinary tract infection in adults: gaps in current guidelines - opinions from an international multidisciplinary panel and relevance to clinical practice.BMC proceedings · 2025Article
- Comorbid psoriasis in systemic lupus erythematosus: a cohort study from a tertiary referral centre and the National Patient Register in Sweden.Lupus science & medicine · 2025Article
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
Abstract
objectivesPatients with SLE have an increased risk of comorbidities and impaired survival. We aimed to assess whether various thresholds of oral CS (OCS) can predict development of infections, comorbidities, malignancies and survival in SLE using data from national health registries in Sweden.
methodsAll incident SLE cases, age >18 years, in Sweden (n = 5309) between 2005 and 2020 and matched population controls (n = 26 545) were included and followed until 2020, a total of 257 942 patient years. Data from national registers were retrieved including information from the National Prescribed Drug Register. Risk factors were analysed using time-dependent Cox regression models.
resultsCompared with no OCS, >0 to <5.0 mg/day, 5.0-7.5 mg/day as well as >7.5 mg/day OCS predicted development of infections (pneumonia, influenza, herpes zoster and urinary tract infection), osteoporosis, osteonecrosis, gastroduodenal ulcers, cataracts, hypertension and mortality (all P < 0.05). OCS >0 to <5.0 mg/day was associated with lower hazard ratios for these comorbidities than higher doses of OCS. Fifteen years after diagnosis, 48% of patients were taking OCS at a median dose of 5.7 mg/day. A small reduction of OCS treatment 5 years after diagnosis in patients diagnosed with SLE 2006-10 compared with 2011-15 was observed, 49% vs 46% respectively (P = 0.039).
conclusionResults highlight the potential harm associated with even low OCS dose treatment in SLE and the need to judiciously use OCS at the lowest possible dose to maximize efficacy and minimize harm.
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