Evidence map›Paper›PMID 38924684›Full record

ArticleACR open rheumatology2024

Unfavorable Outcomes Associated With Glucocorticoid Use in Current Standard-of-Care Management of Systemic Lupus Erythematosus in Canada.

Zahi Touma, Sheena Kayaniyil, Anna Parackal, Denisse Bonilla, Jiandong Su, Christina Qian, Sally D Miller, Adam Johnston, James Gahn, Erik D Hille and 2 more

Abstract read
In one paragraph

Article in ACR open rheumatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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

12 authors.

Zahi ToumaToronto Western Hospital, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0001-5177-2076
Sheena KayaniyilAstraZeneca, Mississauga, Ontario, Canada.
Anna ParackalAstraZeneca, Mississauga, Ontario, Canada.
Denisse BonillaToronto Western Hospital, Toronto, Ontario, Canada.
Jiandong SuToronto Western Hospital, Toronto, Ontario, Canada.
Christina QianBroadstreet Health Economics & Outcomes Research, Vancouver, British Columbia, Canada.
Sally D MillerBroadstreet Health Economics & Outcomes Research, Vancouver, British Columbia, Canada.ORCID https://orcid.org/0000-0003-3649-2927
Adam JohnstonMedical Decision Modeling Inc., Indianapolis, Indiana.
James GahnMedical Decision Modeling Inc., Indianapolis, Indiana.
Erik D HilleMedical Decision Modeling Inc., Indianapolis, Indiana.
Robert OhsfeldtMedical Decision Modeling Inc., Indianapolis, Indiana, and Texas A&M School of Public Health, College Station.
Shelly ChandranAstraZeneca, Mississauga, Ontario, Canada.

Funding

AstraZeneca Canada
6 · The paper itself

Abstract

objectiveOur objective was to describe the administration of glucocorticoids (GCs) and characterize its association with organ damage in a longitudinal systemic lupus erythematosus (SLE) cohort over a time period spanning the introduction of biologics in Canada.

methodsA retrospective observational study was conducted using data from a large SLE cohort in Canada, including adults without lupus nephritis or central nervous system lupus. Patients were observed from time of entry into the cohort to the last available clinic visit (up to December 31, 2020), with a minimum of 24 months of follow-up. Demographic and clinical characteristics, including average disease activity, treatment administration, and prevalence of organ damage, were examined. Organ damage was stratified by GC administration.

resultsA total of 1,255 patients were included. The mean follow-up duration was 10.5 (SD 8.6) years. One hundred eighty-two (15%) patients had organ damage at baseline. More than 80% of patients were prescribed GCs over the follow-up period, almost all patients had long-term GC treatment, and only 5% of patients took any biologics. Organ damage was more frequent in patients with a higher average GC dose and greater years of GC exposure.

conclusionIn this large cohort of patients with SLE, the majority of patients continue to rely on GC for SLE symptom management, with limited administration of biologics. GC administration was correlated with increased irreversible organ damage. Access to novel GC-sparing treatment options is critical to improve long-term outcomes for patients with SLE, especially given the continued reliance on GC despite the introduction of biologics.

Identifiers

PMID38924684
PMCPMC11506555

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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.