Accrual of athersclerotic vascular events in a multicentre inception SLE cohort

Murray B. Urowitz; Dafna D. Gladman; Vernon Farewell; Jiandong Su; Juanita Romero-diaz; Sang-cheol Bae; Paul R. Fortin; Jorge Sanchez‐guerrero; Ann Elaine Clarke; Sasha Bernatsky; Caroline Gordon; John G. Hanly; Daniel J. Wallace; David A. Isenberg; Anisur Rahman; Joan T. Merrill; Ellen Ginzler; Graciela S. Alarcón; W. Winn Chatham; Michelle A. Petri; Ian N. Bruce; Munther A. Khamashta; Cynthia Aranow; Mary Anne Dooley; Susan Manzi; Rosalind Ramsey‐goldman; Ola Nived; Andreas Jönsen; Kristján Steinsson; Asad A. Zoma; Guillermo Ruiz-irastorza; S. Sam Lim; Kenneth C. Kalunian; Murat Ỉnanç; Ronald Vollenhoven; Manuel Ramos‐casals; Diane L. Kamen; Soren Jacobsen; Christine A. Peschken; Anca Askanase; Thomas Stoll

doi:10.1002/art.41392

Accrual of athersclerotic vascular events in a multicentre inception SLE cohort

Murray B. Urowitz, Dafna D. Gladman, Vernon Farewell, Jiandong Su, Juanita Romero-diaz, Sang-cheol Bae, Paul R. Fortin, Jorge Sanchez‐guerrero, Ann Elaine Clarke, Sasha Bernatsky, Caroline Gordon, John G. Hanly, Daniel J. Wallace, David A. Isenberg, Anisur Rahman, Joan T. Merrill, Ellen Ginzler, Graciela S. Alarcón, W. Winn Chatham, Michelle A. PetriIan N. Bruce, Munther A. Khamashta, Cynthia Aranow, Mary Anne Dooley, Susan Manzi, Rosalind Ramsey‐goldman, Ola Nived, Andreas Jönsen, Kristján Steinsson, Asad A. Zoma, Guillermo Ruiz-irastorza, S. Sam Lim, Kenneth C. Kalunian, Murat Ỉnanç, Ronald Vollenhoven, Manuel Ramos‐casals, Diane L. Kamen, Soren Jacobsen, Christine A. Peschken, Anca Askanase, Thomas Stoll

Inflammation and Ageing

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Abstract

Objective In previous studies, atherosclerotic vascular events (AVEs) were shown to occur in ~10% of patients with systemic lupus erythematosus (SLE). We undertook this study to investigate the annual occurrence and potential risk factors for AVEs in a multinational, multiethnic inception cohort of patients with SLE. Methods A large 33‐center cohort of SLE patients was followed up yearly between 1999 and 2017. AVEs were attributed to atherosclerosis based on SLE being inactive at the time of the AVE as well as typical atherosclerotic changes observed on imaging or pathology reports and/or evidence of atherosclerosis elsewhere. Analyses included descriptive statistics, rate of AVEs per 1,000 patient‐years, and univariable and multivariable relative risk regression models. Results Of the 1,848 patients enrolled in the cohort, 1,710 had ≥1 follow‐up visit after enrollment, for a total of 13,666 patient‐years. Of these 1,710 patients, 3.6% had ≥1 AVEs attributed to atherosclerosis, for an event rate of 4.6 per 1,000 patient‐years. In multivariable analyses, lower AVE rates were associated with antimalarial treatment (hazard ratio [HR] 0.54 [95% confidence interval (95% CI) 0.32–0.91]), while higher AVE rates were associated with any prior vascular event (HR 4.00 [95% CI 1.55–10.30]) and a body mass index of >40 kg/m2 (HR 2.74 [95% CI 1.04–7.18]). A prior AVE increased the risk of subsequent AVEs (HR 5.42 [95% CI 3.17–9.27], P < 0.001). Conclusion The prevalence of AVEs and the rate of AVE accrual demonstrated in the present study is much lower than that seen in previously published data. This may be related to better control of both the disease activity and classic risk factors.

Original language	English
Pages (from-to)	1734-1740
Journal	Arthritis and Rheumatology
Volume	72
Issue number	10
Early online date	9 Jun 2020
DOIs	https://doi.org/10.1002/art.41392
Publication status	Published - Nov 2020

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10.1002/art.41392Licence: None: All rights reserved

UrowitzMB2020Accrual
This is the peer reviewed version of the following article: Urowitz, M.B., Gladman, D.D., Farewell, V., Su, J., Romero-Diaz, J., Bae, S., Fortin, P.R., Sanchez‐Guerrero, J., Clarke, A.E., Bernatsky, S., Gordon, C., Hanly, J.G., Wallace, D.J., Isenberg, D.A., Rahman, A., Merrill, J.T., Ginzler, E., Alarcón, G.S., Chatham, W.W., Petri, M.A., Bruce, I.N., Khamashta, M.A., Aranow, C., Dooley, M.A., Manzi, S., Ramsey‐Goldman, R., Nived, O., Jönsen, A., Steinsson, K., Zoma, A.A., Ruiz-Irastorza, G., Lim, S.S., Kalunian, K.C., Ỉnanç, M., van Vollenhoven, R., Ramos‐Casals, M., Kamen, D.L., Jacobsen, S., Peschken, C.A., Askanase, A. and Stoll, T. (2020), Accrual of Atherosclerotic Vascular Events in a Multicenter Inception Systemic Lupus Erythematosus Cohort. Arthritis Rheumatol, 72: 1734-1740, which has been published in final form at https://doi.org/10.1002/art.41392. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Accepted author manuscript, 289 KBLicence: None: All rights reserved

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Urowitz, M. B., Gladman, D. D., Farewell, V., Su, J., Romero-diaz, J., Bae, S., Fortin, P. R., Sanchez‐guerrero, J., Clarke, A. E., Bernatsky, S., Gordon, C., Hanly, J. G., Wallace, D. J., Isenberg, D. A., Rahman, A., Merrill, J. T., Ginzler, E., Alarcón, G. S., Chatham, W. W., ... Stoll, T. (2020). Accrual of athersclerotic vascular events in a multicentre inception SLE cohort. Arthritis and Rheumatology, 72(10), 1734-1740. https://doi.org/10.1002/art.41392

@article{0187b176ad6e490da50a17ff4399d088,

title = "Accrual of athersclerotic vascular events in a multicentre inception SLE cohort",

abstract = "Objective In previous studies, atherosclerotic vascular events (AVEs) were shown to occur in ~10% of patients with systemic lupus erythematosus (SLE). We undertook this study to investigate the annual occurrence and potential risk factors for AVEs in a multinational, multiethnic inception cohort of patients with SLE. Methods A large 33‐center cohort of SLE patients was followed up yearly between 1999 and 2017. AVEs were attributed to atherosclerosis based on SLE being inactive at the time of the AVE as well as typical atherosclerotic changes observed on imaging or pathology reports and/or evidence of atherosclerosis elsewhere. Analyses included descriptive statistics, rate of AVEs per 1,000 patient‐years, and univariable and multivariable relative risk regression models. Results Of the 1,848 patients enrolled in the cohort, 1,710 had ≥1 follow‐up visit after enrollment, for a total of 13,666 patient‐years. Of these 1,710 patients, 3.6% had ≥1 AVEs attributed to atherosclerosis, for an event rate of 4.6 per 1,000 patient‐years. In multivariable analyses, lower AVE rates were associated with antimalarial treatment (hazard ratio [HR] 0.54 [95% confidence interval (95% CI) 0.32–0.91]), while higher AVE rates were associated with any prior vascular event (HR 4.00 [95% CI 1.55–10.30]) and a body mass index of >40 kg/m2 (HR 2.74 [95% CI 1.04–7.18]). A prior AVE increased the risk of subsequent AVEs (HR 5.42 [95% CI 3.17–9.27], P < 0.001). Conclusion The prevalence of AVEs and the rate of AVE accrual demonstrated in the present study is much lower than that seen in previously published data. This may be related to better control of both the disease activity and classic risk factors.",

author = "Urowitz, {Murray B.} and Gladman, {Dafna D.} and Vernon Farewell and Jiandong Su and Juanita Romero-diaz and Sang-cheol Bae and Fortin, {Paul R.} and Jorge Sanchez‐guerrero and Clarke, {Ann Elaine} and Sasha Bernatsky and Caroline Gordon and Hanly, {John G.} and Wallace, {Daniel J.} and Isenberg, {David A.} and Anisur Rahman and Merrill, {Joan T.} and Ellen Ginzler and Alarc{\'o}n, {Graciela S.} and Chatham, {W. Winn} and Petri, {Michelle A.} and Bruce, {Ian N.} and Khamashta, {Munther A.} and Cynthia Aranow and Dooley, {Mary Anne} and Susan Manzi and Rosalind Ramsey‐goldman and Ola Nived and Andreas J{\"o}nsen and Kristj{\'a}n Steinsson and Zoma, {Asad A.} and Guillermo Ruiz-irastorza and Lim, {S. Sam} and Kalunian, {Kenneth C.} and Murat Ỉnan{\c c} and Ronald Vollenhoven and Manuel Ramos‐casals and Kamen, {Diane L.} and Soren Jacobsen and Peschken, {Christine A.} and Anca Askanase and Thomas Stoll",

year = "2020",

month = nov,

doi = "10.1002/art.41392",

language = "English",

volume = "72",

pages = "1734--1740",

journal = "Arthritis and Rheumatology",

issn = "2326-5191",

publisher = "Wiley",

number = "10",

}

Urowitz, MB, Gladman, DD, Farewell, V, Su, J, Romero-diaz, J, Bae, S, Fortin, PR, Sanchez‐guerrero, J, Clarke, AE, Bernatsky, S, Gordon, C, Hanly, JG, Wallace, DJ, Isenberg, DA, Rahman, A, Merrill, JT, Ginzler, E, Alarcón, GS, Chatham, WW, Petri, MA, Bruce, IN, Khamashta, MA, Aranow, C, Dooley, MA, Manzi, S, Ramsey‐goldman, R, Nived, O, Jönsen, A, Steinsson, K, Zoma, AA, Ruiz-irastorza, G, Lim, SS, Kalunian, KC, Ỉnanç, M, Vollenhoven, R, Ramos‐casals, M, Kamen, DL, Jacobsen, S, Peschken, CA, Askanase, A & Stoll, T 2020, 'Accrual of athersclerotic vascular events in a multicentre inception SLE cohort', Arthritis and Rheumatology, vol. 72, no. 10, pp. 1734-1740. https://doi.org/10.1002/art.41392

TY - JOUR

T1 - Accrual of athersclerotic vascular events in a multicentre inception SLE cohort

AU - Urowitz, Murray B.

AU - Gladman, Dafna D.

AU - Farewell, Vernon

AU - Su, Jiandong

AU - Romero-diaz, Juanita

AU - Bae, Sang-cheol

AU - Fortin, Paul R.

AU - Sanchez‐guerrero, Jorge

AU - Clarke, Ann Elaine

AU - Bernatsky, Sasha

AU - Gordon, Caroline

AU - Hanly, John G.

AU - Wallace, Daniel J.

AU - Isenberg, David A.

AU - Rahman, Anisur

AU - Merrill, Joan T.

AU - Ginzler, Ellen

AU - Alarcón, Graciela S.

AU - Chatham, W. Winn

AU - Petri, Michelle A.

AU - Bruce, Ian N.

AU - Khamashta, Munther A.

AU - Aranow, Cynthia

AU - Dooley, Mary Anne

AU - Manzi, Susan

AU - Ramsey‐goldman, Rosalind

AU - Nived, Ola

AU - Jönsen, Andreas

AU - Steinsson, Kristján

AU - Zoma, Asad A.

AU - Ruiz-irastorza, Guillermo

AU - Lim, S. Sam

AU - Kalunian, Kenneth C.

AU - Ỉnanç, Murat

AU - Vollenhoven, Ronald

AU - Ramos‐casals, Manuel

AU - Kamen, Diane L.

AU - Jacobsen, Soren

AU - Peschken, Christine A.

AU - Askanase, Anca

AU - Stoll, Thomas

PY - 2020/11

Y1 - 2020/11

N2 - Objective In previous studies, atherosclerotic vascular events (AVEs) were shown to occur in ~10% of patients with systemic lupus erythematosus (SLE). We undertook this study to investigate the annual occurrence and potential risk factors for AVEs in a multinational, multiethnic inception cohort of patients with SLE. Methods A large 33‐center cohort of SLE patients was followed up yearly between 1999 and 2017. AVEs were attributed to atherosclerosis based on SLE being inactive at the time of the AVE as well as typical atherosclerotic changes observed on imaging or pathology reports and/or evidence of atherosclerosis elsewhere. Analyses included descriptive statistics, rate of AVEs per 1,000 patient‐years, and univariable and multivariable relative risk regression models. Results Of the 1,848 patients enrolled in the cohort, 1,710 had ≥1 follow‐up visit after enrollment, for a total of 13,666 patient‐years. Of these 1,710 patients, 3.6% had ≥1 AVEs attributed to atherosclerosis, for an event rate of 4.6 per 1,000 patient‐years. In multivariable analyses, lower AVE rates were associated with antimalarial treatment (hazard ratio [HR] 0.54 [95% confidence interval (95% CI) 0.32–0.91]), while higher AVE rates were associated with any prior vascular event (HR 4.00 [95% CI 1.55–10.30]) and a body mass index of >40 kg/m2 (HR 2.74 [95% CI 1.04–7.18]). A prior AVE increased the risk of subsequent AVEs (HR 5.42 [95% CI 3.17–9.27], P < 0.001). Conclusion The prevalence of AVEs and the rate of AVE accrual demonstrated in the present study is much lower than that seen in previously published data. This may be related to better control of both the disease activity and classic risk factors.

AB - Objective In previous studies, atherosclerotic vascular events (AVEs) were shown to occur in ~10% of patients with systemic lupus erythematosus (SLE). We undertook this study to investigate the annual occurrence and potential risk factors for AVEs in a multinational, multiethnic inception cohort of patients with SLE. Methods A large 33‐center cohort of SLE patients was followed up yearly between 1999 and 2017. AVEs were attributed to atherosclerosis based on SLE being inactive at the time of the AVE as well as typical atherosclerotic changes observed on imaging or pathology reports and/or evidence of atherosclerosis elsewhere. Analyses included descriptive statistics, rate of AVEs per 1,000 patient‐years, and univariable and multivariable relative risk regression models. Results Of the 1,848 patients enrolled in the cohort, 1,710 had ≥1 follow‐up visit after enrollment, for a total of 13,666 patient‐years. Of these 1,710 patients, 3.6% had ≥1 AVEs attributed to atherosclerosis, for an event rate of 4.6 per 1,000 patient‐years. In multivariable analyses, lower AVE rates were associated with antimalarial treatment (hazard ratio [HR] 0.54 [95% confidence interval (95% CI) 0.32–0.91]), while higher AVE rates were associated with any prior vascular event (HR 4.00 [95% CI 1.55–10.30]) and a body mass index of >40 kg/m2 (HR 2.74 [95% CI 1.04–7.18]). A prior AVE increased the risk of subsequent AVEs (HR 5.42 [95% CI 3.17–9.27], P < 0.001). Conclusion The prevalence of AVEs and the rate of AVE accrual demonstrated in the present study is much lower than that seen in previously published data. This may be related to better control of both the disease activity and classic risk factors.

U2 - 10.1002/art.41392

DO - 10.1002/art.41392

M3 - Article

SN - 2326-5191

VL - 72

SP - 1734

EP - 1740

JO - Arthritis and Rheumatology

JF - Arthritis and Rheumatology

IS - 10

ER -

Accrual of athersclerotic vascular events in a multicentre inception SLE cohort

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