Kandane-Rathnayake, Rangi and Louthrenoo, Worawit and Luo, Shue-Fen and Wu, Yeong-Jian J. and Chen, Yi-Hsing and Golder, Vera and Lateef, Aisha and Cho, Jiacai and Navarra, Sandra and Zamora, Leonid and Hamijoyo, Laniyati and Sockalingam, Sargunan and An, Yuan and Li, Zhanguo and Montes, Ricardo and Oon, Shereen and Katsumata, Yasuhiro and Harigai, Masayoshi and Hao, Yanjie and Zhang, Zhuoli and Chan, Madelynn and Kikuchi, Jun and Takeuchi, Tsutomu and Goldblatt, Fiona and O'Neill, Sean and Bae, Sang-Cheol and Lau, Chak S. and Hoi, Alberta and Karyekar, Chetan S. and Nikpour, Mandana and Morand, Eric F. and Collaboration, Asia-Pacific Lupus (2022) Patterns of medication use in systemic lupus erythematosus: A multicenter cohort study. Arthritis Care & Research, 74 (12). pp. 2033-2041. ISSN 2151-4658, DOI https://doi.org/10.1002/acr.24740.
Full text not available from this repository.Abstract
Objective Evidence for the utility of medications in settings lacking randomized trial data can come from studies of treatment persistence. The present study was undertaken to examine patterns of medication use in systemic lupus erythematosus (SLE) using data from a large multicenter longitudinal cohort. Methods Prospectively collected data from the Asia Pacific Lupus Collaboration cohort including disease activity (SLE Disease Activity Index 2000 SLEDAI-2K]) and medication details, captured at every visit from 2013-2018, were used. Medications were categorized as glucocorticoids (GCs), antimalarials (AM), and immunosuppressants (IS). Cox regression analyses were performed to determine the time-to-discontinuation of medications, stratified by SLE disease activity. Results Data from 19,804 visits of 2,860 patients were analyzed. Eight medication categories were observed: no treatment; GC, AM, or IS only; GC plus AM; GC plus IS; AM plus IS; and GC plus AM plus IS (triple therapy). Triple therapy was the most frequent pattern (31.4% of visits); single agents were used in 21% of visits, and biologics in only 3%. Time-to-discontinuation analysis indicated that medication persistence varied widely, with the highest treatment persistence for AM and lowest for IS. Patients with a time-adjusted mean SLEDAI-2K score of >= 10 had lower discontinuation of GCs and higher discontinuation of IS. Conclusion Most patients received combination treatment. GC persistence was high, while IS persistence was low. Patients with high disease activity received more medication combinations but had reduced IS persistence, consistent with limited utility. These data confirm unmet need for improved SLE treatments.
| Item Type: | Article |
|---|---|
| Funders: | None |
| Uncontrolled Keywords: | Rheumatoid-arthritis; Antirheumatic drugs; Disease-activity; Damage; Classification; Methotrexate; Etanercept; Management; Criteria |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Medicine Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 15 Jul 2024 07:37 |
| Last Modified: | 15 Jul 2024 07:55 |
| URI: | http://eprints.um.edu.my/id/eprint/40431 |
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