| アブストラクト | OBJECTIVES: We wanted to estimate the magnitude of the risk from all-cause, cause-specific and sex-specific mortality in patients with SLE and relative risks compared with matched controls and to evaluate the influence of exposure to medication on risk of mortality in SLE. METHODS: We conducted a population-based cohort study using the Clinical Practice Research Datalink, Hospital Episode Statistics and national death certificates (from 1987 to 2012). Each SLE patient (n = 4343) was matched with up to six controls (n = 21 780) by age and sex. Cox proportional hazards models were used to estimate overall and cause-specific mortality rate ratios. RESULTS: Patients with SLE had a 1.8-fold increased mortality rate for all-cause mortality compared with age- and sex-matched subjects [adjusted hazard ratio (HR) = 1.80, 95% CI: 1.57, 2.08]. The HR was highest in patients aged 18-39 years (adjusted HR = 4.87, 95% CI: 1.93, 12.3). Mortality rates were not significantly different between male and female patients. Cumulative glucocorticoid use raised the mortality rate, whereas the HR was reduced by 45% with cumulative low-dose HCQ use. Patients with SLE had increased cause-specific mortality rates for cardiovascular disease, infections, non-infectious respiratory disease and for death attributable to accidents or suicide, whereas the mortality rate for cancer was reduced in comparison to controls. CONCLUSION: British patients with SLE had a 1.8-fold increased mortality rate compared with the general population. Glucocorticoid use and being diagnosed at a younger age were associated with an increased risk of mortality. HCQ use significantly reduced the mortality rate, but this association was found only in the lowest cumulative dosage exposure group. |
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| ジャーナル名 | Rheumatology (Oxford, England) |
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| Pubmed追加日 | 2020/7/13 |
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| 投稿者 | Bultink, Irene E M; de Vries, Frank; van Vollenhoven, Ronald F; Lalmohamed, Arief |
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| 組織名 | Department of Rheumatology, Amsterdam Rheumatology and immunology Center, VU;University Medical Center, Amsterdam.;Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University,;Utrecht.;Department of Clinical Pharmacy and Toxicology, Maastricht University Medical;Centre, Maastricht.;Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The;Netherlands. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/32653901/ |
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