Risk of Myocardial Infarction and Stroke in Newly Diagnosed Systemic Lupus Erythematosus: A General Population-Based Study

2017 ◽  
Vol 69 (6) ◽  
pp. 849-856 ◽  
Author(s):  
J. Antonio Aviña-Zubieta ◽  
Fergus To ◽  
Kateryna Vostretsova ◽  
Mary De Vera ◽  
Eric C. Sayre ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systemic Lupus Erythematosus ◽  
General Population ◽  
Lupus Erythematosus ◽  
Population Based ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Population Based Study

scholarly journals Incremental direct medical costs of systemic lupus erythematosus patients in the years preceding diagnosis: A general population-based study

Lupus ◽  
2018 ◽  
Vol 27 (8) ◽  
pp. 1247-1258 ◽  
Author(s):  
N McCormick ◽  
C A Marra ◽  
M Sadatsafavi ◽  
J A Aviña-Zubieta
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Socioeconomic Status ◽  
General Population ◽  
Lupus Erythematosus ◽  
Medical Costs ◽  
Population Based ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Direct Medical Costs ◽  
The Impact

Objective We estimated the incremental (extra) direct medical costs of a population-based cohort of newly diagnosed systemic lupus erythematosus (SLE) for five years before and after diagnosis, and the impact of sex and socioeconomic status (SES) on pre-index costs for SLE. Methods We identified all adults newly diagnosed with SLE over 2001–2010 in British Columbia, Canada, and obtained a sample of non-SLE individuals from the general population, matched on sex, age, and calendar-year of study entry. We captured costs for all outpatient encounters, hospitalisations, and dispensed medications each year. Using generalised linear models, we estimated incremental costs of SLE each year before/after diagnosis (difference in costs between SLE and non-SLE, controlling for covariates). Similar models were used to examine the impact of sex and SES on costs within SLE. Results We included 3632 newly diagnosed SLE (86% female, mean age 49.6 ± 15.9) and 18,060 non-SLE individuals. Over the five years leading up to diagnosis, per-person healthcare costs for SLE patients increased year-over-year by 35%, on average, with the biggest increases in the final two years by 39% and 97%, respectively. Per-person all-cause medical costs for SLE the year after diagnosis (Year + 1) averaged C$12,019 (2013 Canadian) with 58% from hospitalisations, 24% outpatient, and 18% from prescription medications; Year + 1 costs for non-SLE averaged C$2412. Following adjustment for age, sex, urban/rural residence, socioeconomic status, and prior year's comorbidity score, SLE was associated with significantly greater hospitalisation, outpatient, and medication costs than non-SLE in each year of study. Altogether, adjusted incremental costs of SLE rose from C$1131 per person in Year –5 (fifth year before diagnosis) to C$2015 (Year –2), C$3473 (Year –1) and C$6474 (Year + 1). In Years –2, –1 and +1, SLE patients in the lowest SES group had significantly greater costs than the highest SES. Unlike the non-SLE cohort, male patients with SLE had higher costs than females. Annual incremental costs of SLE males (vs. SLE females) rose from C$540 per person in Year –2, to C$1385 in Year –1, and C$2288 in Year + 1. Conclusion Even years before diagnosis, SLE patients incur significantly elevated direct medical costs compared with the age- and sex-matched general population, for hospitalisations, outpatient care, and medications.

scholarly journals Risk of Systemic Lupus Erythematosus in Patients With Anti-phospholipid Syndrome: A Population-Based Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Hsin-Hua Chen ◽  
Ching-Heng Lin ◽  
Wen-Cheng Chao
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Population Based ◽  
Sensitivity Analyses ◽  
Research Database ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Population Based Study ◽  
Increased Risk ◽  
Anti Phospholipid Syndrome

Objective: To investigate the association between anti-phospholipid syndrome (APS) and the risk of newly diagnosed systemic lupus erythematosus (SLE).Methods: We used 2003–2013 data derived from Taiwan's National Health Insurance Research Database to conduct this nationwide, population-based. We identified AS patients newly diagnosed between 2005 to 2013 as the study group and applied age-sex matched (1:20) and propensity score-matched (PSM) (1:2) non-SLE individuals as controls. The association between APS and risk of incident SLE was determined by calculating hazard ratios (HRs) with 95% confidence intervals (CIs) using Cox proportional hazard regression analysis.Results: We identified 1,245 patients with APS as well as 24,900 age- and sex-matched non-APS controls and 727 APS patients as well as 1,454 PSM non-APS controls. We found that the risk for incident SLE in the APS group was 80.70 times higher than the non-APS group, and the association remained robust after PSM (HR, 28.55; 95% CI, 11.49–70.91). The increased risk for SLE in patients with APS mainly existed within 5 years after the diagnosis of APS. The sensitivity analyses found that the risk for SLE in patients with APS was consistent excluding patients with ITP/AIHA and using distinct definitions of SLE.Conclusion: The present population-based study revealed a robust association between SLE risk and recent APS and highlights the need for vigilance of SLE-associated symptoms in patients who had been diagnosed with APS.

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