dc.contributor | Landspitali - The National University Hospital of Iceland |
dc.contributor.author | Almeida-Brasil, Celline C |
dc.contributor.author | Hanly, John G |
dc.contributor.author | Urowitz, Murray |
dc.contributor.author | Clarke, Ann Elaine |
dc.contributor.author | Ruiz-Irastorza, Guillermo |
dc.contributor.author | Gordon, Caroline |
dc.contributor.author | Ramsey-Goldman, Rosalind |
dc.contributor.author | Petri, Michelle |
dc.contributor.author | Ginzler, Ellen M |
dc.contributor.author | Wallace, D J |
dc.contributor.author | Bae, Sang-Cheol |
dc.contributor.author | Romero-Diaz, Juanita |
dc.contributor.author | Dooley, Mary Anne |
dc.contributor.author | Peschken, Christine |
dc.contributor.author | Isenberg, David |
dc.contributor.author | Rahman, Anisur |
dc.contributor.author | Manzi, Susan |
dc.contributor.author | Jacobsen, Søren |
dc.contributor.author | Lim, Sam |
dc.contributor.author | van Vollenhoven, Ronald F |
dc.contributor.author | Nived, Ola |
dc.contributor.author | Jönsen, Andreas |
dc.contributor.author | Kamen, Diane L |
dc.contributor.author | Aranow, Cynthia |
dc.contributor.author | Sanchez-Guerrero, Jorge |
dc.contributor.author | Gladman, Dafna D |
dc.contributor.author | Fortin, Paul R |
dc.contributor.author | Alarcón, Graciela S |
dc.contributor.author | Merrill, Joan T |
dc.contributor.author | Kalunian, Kenneth |
dc.contributor.author | Ramos-Casals, Manuel |
dc.contributor.author | Steinsson, Kristján |
dc.contributor.author | Zoma, Asad |
dc.contributor.author | Askanase, Anca |
dc.contributor.author | Khamashta, Munther A |
dc.contributor.author | Bruce, Ian N |
dc.contributor.author | Inanc, Murat |
dc.contributor.author | Abrahamowicz, Michal |
dc.contributor.author | Bernatsky, Sasha |
dc.date.accessioned | 2023-03-29T01:04:16Z |
dc.date.available | 2023-03-29T01:04:16Z |
dc.date.issued | 2022-02-14 |
dc.identifier.citation | Almeida-Brasil , C C , Hanly , J G , Urowitz , M , Clarke , A E , Ruiz-Irastorza , G , Gordon , C , Ramsey-Goldman , R , Petri , M , Ginzler , E M , Wallace , D J , Bae , S-C , Romero-Diaz , J , Dooley , M A , Peschken , C , Isenberg , D , Rahman , A , Manzi , S , Jacobsen , S , Lim , S , van Vollenhoven , R F , Nived , O , Jönsen , A , Kamen , D L , Aranow , C , Sanchez-Guerrero , J , Gladman , D D , Fortin , P R , Alarcón , G S , Merrill , J T , Kalunian , K , Ramos-Casals , M , Steinsson , K , Zoma , A , Askanase , A , Khamashta , M A , Bruce , I N , Inanc , M , Abrahamowicz , M & Bernatsky , S 2022 , ' Flares after hydroxychloroquine reduction or discontinuation: results from the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort. ' , Annals of the Rheumatic Diseases , vol. 81 , no. 3 , pp. 370-378 . https://doi.org/10.1136/annrheumdis-2021-221295 |
dc.identifier.issn | 0003-4967 |
dc.identifier.other | 48992896 |
dc.identifier.other | 2698acf3-0c18-43e1-90cf-c8e1e5a9dcc4 |
dc.identifier.other | researchoutputwizard: hdl.handle.net/2336/622072 |
dc.identifier.other | 34911705 |
dc.identifier.other | 85124635089 |
dc.identifier.uri | https://hdl.handle.net/20.500.11815/4101 |
dc.description.abstract | Objectives: To evaluate systemic lupus erythematosus (SLE) flares following hydroxychloroquine (HCQ) reduction or discontinuation versus HCQ maintenance. Methods: We analysed prospective data from the Systemic Lupus International Collaborating Clinics (SLICC) cohort, enrolled from 33 sites within 15 months of SLE diagnosis and followed annually (1999-2019). We evaluated person-time contributed while on the initial HCQ dose ('maintenance'), comparing this with person-time contributed after a first dose reduction, and after a first HCQ discontinuation. We estimated time to first flare, defined as either subsequent need for therapy augmentation, increase of ≥4 points in the SLE Disease Activity Index-2000, or hospitalisation for SLE. We estimated adjusted HRs (aHRs) with 95% CIs associated with reducing/discontinuing HCQ (vs maintenance). We also conducted separate multivariable hazard regressions in each HCQ subcohort to identify factors associated with flare. Results: We studied 1460 (90% female) patients initiating HCQ. aHRs for first SLE flare were 1.20 (95% CI 1.04 to 1.38) and 1.56 (95% CI 1.31 to 1.86) for the HCQ reduction and discontinuation groups, respectively, versus HCQ maintenance. Patients with low educational level were at particular risk of flaring after HCQ discontinuation (aHR 1.43, 95% CI 1.09 to 1.87). Prednisone use at time-zero was associated with over 1.5-fold increase in flare risk in all HCQ subcohorts. Conclusions: SLE flare risk was higher after HCQ taper/discontinuation versus HCQ maintenance. Decisions to maintain, reduce or stop HCQ may affect specific subgroups differently, including those on prednisone and/or with low education. Further study of special groups (eg, seniors) may be helpful. Keywords: autoimmune diseases; epidemiology; hydroxychloroquine; systemic lupus erythematosus. |
dc.format.extent | 1442655 |
dc.format.extent | 370-378 |
dc.language.iso | en |
dc.relation.ispartofseries | Annals of the Rheumatic Diseases; 81(3) |
dc.rights | info:eu-repo/semantics/openAccess |
dc.subject | Gigtarlæknisfræði |
dc.subject | autoimmune diseases |
dc.subject | epidemiology |
dc.subject | hydroxychloroquine |
dc.subject | systemic lupus erythematosus |
dc.subject | Rauðir úlfar |
dc.subject | Lupus Erythematosus, Systemic |
dc.subject | Hydroxychloroquine |
dc.subject | autoimmune diseases |
dc.subject | epidemiology |
dc.subject | hydroxychloroquine |
dc.subject | systemic lupus erythematosus |
dc.subject | Rauðir úlfar |
dc.subject | Lupus Erythematosus, Systemic |
dc.subject | Hydroxychloroquine |
dc.title | Flares after hydroxychloroquine reduction or discontinuation: results from the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort. |
dc.type | /dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article |
dc.description.version | Peer reviewed |
dc.identifier.doi | 10.1136/annrheumdis-2021-221295 |
dc.relation.url | https://ard.bmj.com/content/81/3/370.long |