Browsing by Author "Esposto, A."

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    Factors predictive of serious infections over time in systemic lupus erythematosus patients: data from a multi-ethnic, multi-national, Latin American lupus cohort
    (2019) Pimentel-Quiroz, V. R.; Ugarte-Gil, M. F.; Harvey, G. B.; Wojdyla, D.; Pons-Estel, G. J.; Quintana, R.; Esposto, A.; Garcia, M. A.; Catoggio, L. J.; Cardiel, M. H.; Barile, L. A.; Amigo, M-C; Sato, E., I; Bonfa, E.; Borba, E.; Lavras Costallat, L. T.; Neira, O. J.; Massardo, L.; Guibert-Toledano, M.; Chacon-Diaz, R.; Alarcon, G. S.; Pons-Estel, B. A.; Soriano, Enrique R.; Ceballos Recalde, Maria Flavia; Velozo, Edson; Manni, Jorge A.; Grimaudo, Sebastian; Sarano, Judith; Maldonado-Cocco, Jose A.; Arriola, Maria S.; Gomez, Graciela; Ines Marcos, Ana; Carlos Marcos, Juan; Scherbarth, Hugo R.; Lopez, Jorge A.; Motta, Estela L.; Drenkard, Cristina; Gamron, Susana; Buliubasich, Sandra; Onetti, Laura; Caeiro, Francisco; Alvarellos, Alejandro; Saurit, Veronica; Gentiletti, Silvana; Quagliatto, Norberto; Gentiletti, Alberto A.; Machado, Daniel; Abdala, Marcelo; Palatnik, Simon; Berbotto, Guillermo A.; Battagliotti, Carlos A.; Souza, Alexandre Wagner S.; Bertolo, Manoel Barros; Coimbra, Ibsen Bellini; Tavares Brenol, Joao C.; Monticielo, Odirlei; Xavier, Ricardo; Cavalcanti, Fernando de Souza; Branco Duarte, Angela Luzia; Lopes Marques, Claudia Diniz; da Silva, Nilzio Antonio; de O e Silva, Ana Carolina; Pacheco, Tatiana Ferracine; Fernando Molina-Restrepo, Jose; Molina-Lopez, Javier; Vasquez, Gloria; Ramirez, Luis A.; Uribe, Oscar; Iglesias-Gamarra, Antonio; Iglesias-Rodriguez, Antonio; Egea-Bermejo, Eduardo; Guzman-Moreno, Renato A.; Restrepo-Suarez, Jose F.; Alberto Reyes-Llerena, Gil; Hernandez-Martinez, Alfredo; Jacobelli, Sergio; Guzman, Leonardo R.; Garcia-Kutzbach, Abraham; Castellanos, Claudia; Cajas, Erwin; Pascual-Ramos, Virginia; Silveira, Luis H.; Garcia De La Torre, Ignacio; Orozco-Barocio, Gerardo; Estrada-Contreras, Magali L.; Sauza del Pozo, Maria Josefina; Aranda Baca, Laura E.; Urenda Quezada, Adelfia; Huerta-Yanez, Guillermo F.; Acevedo-Vazquez, Eduardo M.; Luis Alfaro-Lozano, Jose; Cucho-Venegas, Jorge M.; Ines Segami, Maria; Chung, Cecilia P.; Alva-Linares, Magaly; Abadi, Isaac; Rangel, Neriza; Al Snih Al Snih, Soham; Esteva-Spinetti, Maria H.; Vivas, Jorge
    Aim The aim of this study was to identify factors predictive of serious infections over time in patients with systemic lupus erythematosus (SLE). Methods A multi-ethnic, multi-national Latin American SLE cohort was studied. Serious infection was defined as one that required hospitalization, occurred during a hospitalization or led to death. Potential predictors included were sociodemographic factors, clinical manifestations (per organ involved, lymphopenia and leukopenia, independently) and previous infections at baseline. Disease activity (SLEDAI), damage (SLICC/ACR Damage Index), non-serious infections, glucocorticoids, antimalarials (users and non-users), and immunosuppressive drugs use; the last six variables were examined as time-dependent covariates. Cox regression models were used to evaluate the predictors of serious infections using a backward elimination procedure. Univariable and multivariable analyses were performed. Results Of the 1243 patients included, 1116 (89.8%) were female. The median (interquartile range) age at diagnosis and follow-up time were 27 (20-37) years and 47.8 (17.9-68.6) months, respectively. The incidence rate of serious infections was 3.8 cases per 100 person-years. Antimalarial use (hazard ratio: 0.69; 95% confidence interval (CI): 0.48-0.99; p = 0.0440) was protective, while doses of prednisone >15 and <= 60 mg/day (hazard ratio: 4.18; 95 %CI: 1.69-10.31; p = 0.0019) and >60 mg/day (hazard ratio: 4.71; 95% CI: 1.35-16.49; p = 0.0153), use of methylprednisolone pulses (hazard ratio: 1.53; 95% CI: 1.10-2.13; p = 0.0124), increase in disease activity (hazard ratio: 1.03; 95% CI: 1.01-1.04; p = 0.0016) and damage accrual (hazard ratio: 1.22; 95% CI: 1.11-1.34; p < 0.0001) were predictive factors of serious infections. Conclusions Over time, prednisone doses higher than 15 mg/day, use of methylprednisolone pulses, increase in disease activity and damage accrual were predictive of infections, whereas antimalarial use was protective against them in SLE patients.