%0 Journal Article
%A Ruiz-Irastorza, G
%A Garcia, M
%A Espinosa, G
%A Caminal, L
%A Mitjavila, F
%A González-León, R
%A Sopeña, B
%A Canora, J
%A Villalba, M V
%A Rodríguez-Carballeira, M
%A López-Dupla, J M
%A Callejas, J L
%A Castro, A
%A Tolosa, C
%A Sánchez-García, M E
%A Pérez-Conesa, M
%A Navarrete-Navarrete, N
%A Rodríguez, A P
%A Herranz, M T
%A Pallarés, L
%T First month prednisone dose predicts prednisone burden during the following 11 months: an observational study from the RELES cohort.
%D 2016
%U http://hdl.handle.net/10668/2498
%X AIMTo study the influence of prednisone dose during the first month after systemic lupus erythematosus (SLE) diagnosis (prednisone-1) on glucocorticoid burden during the subsequent 11 months (prednisone-2-12).METHODS223 patients from the Registro Español de Lupus Eritematoso Sistémico inception cohort were studied. The cumulative dose of prednisone-1 and prednisone-2-12 were calculated and recoded into a four-level categorical variable: no prednisone, low dose (up to 7.5 mg/day), medium dose (up to 30 mg/day) and high dose (over 30 mg/day). The association between the cumulative prednisone-1 and prednisone-2-12 doses was tested. We analysed whether the four-level prednisone-1 categorical variable was an independent predictor of an average dose >7.5 mg/day of prednisone-2-12. Adjusting variables included age, immunosuppressives, antimalarials, methyl-prednisolone pulses, lupus nephritis and baseline SLE Disease Activity Index (SLEDAI).RESULTSWithin the first month, 113 patients (51%) did not receive any prednisone, 24 patients (11%) received average low doses, 46 patients (21%) received medium doses and 40 patients (18%) received high doses. There was a strong association between prednisone-1 and prednisone-2-12 dose categories (p<0.001). The cumulative prednisone-1 dose was directly associated with the cumulative prednisone-2-12 dose (p<0.001). Compared with patients on no prednisone, patients taking medium (adjusted OR 5.27, 95% CI 2.18 to 12.73) or high-dose prednisone-1 (adjusted OR 10.5, 95% CI 3.8 to 29.17) were more likely to receive prednisone-2-12 doses of >7.5 mg/day, while patients receiving low-dose prednisone-1 were not (adjusted OR 1.4, 95% CI 0. 0.38 to 5.2). If the analysis was restricted to the 158 patients with a baseline SLEDAI of ≥6, the model did not change.CONCLUSIONThe dose of prednisone during the first month after the diagnosis of SLE is an independent predictor of prednisone burden during the following 11 months.
%K Antimaláricos
%K Glucocorticoides
%K Humanos
%K Inmunosupresores
%K Lupus eritematoso discoide
%K Lupus eritematoso sistémico
%K Nefritis lúpica
%K Metilprednisolona
%K Prednisona
%K Pulso arterial
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