Response to: ‘Bone health, an often forgotten comorbidity in systemic lupus erythematosus: a comment on the new recommendations’ by Orsolini <i>et al</i>

Fanouriakis, Antonis; Βertsias, George; Boumpas, Dimitrios T.

doi:10.1136/annrheumdis-2019-215944

Cited by 1 publication

(2 citation statements)

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“… 1 15 Whereas the regular use of glucocorticoids is likely to be responsible for osteoporosis in long-standing disease, it cannot be causal in incident disease. Pre-existing disease activity and premature menopause are more likely to be reasons for prevalent osteoporosis at SLE onset, 4 5 making early screening and risk assessment for fractures essential. It is also possible that the increase in osteoporosis codes for SLE may be due, in part, to heightened evaluation of osteoporosis risk after initiation of glucocorticoids or due to preventative osteoporosis therapies.…”

Section: Discussionmentioning

confidence: 99%

“… 3 In addition, bone health is considered a major comorbidity target. 4 5 So far, there have been only limited data on comorbidities in people with SLE in Germany. Patients with SLE who are treated in specialised arthritis centres are documented in the German National Database 6 ; however, majority of patients have long-standing disease and numbers on incident SLE cases are small.…”

Section: Introductionmentioning

confidence: 99%

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Comorbidity and healthcare utilisation in persons with incident systemic lupus erythematosus followed for 3 years after diagnosis: analysis of a claims data cohort

et al. 2021

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ObjectiveTo analyse comorbidity and healthcare utilisation in individuals with SLE.MethodsA cohort of individuals with incident SLE diagnosis in 2016 were investigated using claims data from a German statutory health insurance fund. Concomitant diagnoses, medical prescriptions, hospitalisation and sick leave were analysed in the year prior to diagnosis and during a 3-year follow-up in comparison with age-matched and sex-matched controls (1) without autoimmune diseases and (2) with incident diabetes mellitus. Sensitivity analyses were performed excluding cases with additional autoimmune diagnoses and without prescription of antimalarials.ResultsAmong 571 individuals with SLE, hypertension (48%), depression (30%), hyperlipidaemia (25%), osteoarthritis (25%) and osteoporosis (20%) were the most frequent comorbidities in 2016. Cerebrovascular disease was documented in 9.6%. The number of drugs (mean 9.6, ∆+6.2), hospitalisation (40%, ∆+27%) and days on sick leave (median 46 days, ∆+27 days) increased significantly in the first year with SLE diagnosis. Individuals with SLE were more frequently hospitalised and had more medications compared with both control groups (all p<0.001). The increase in comorbidity diagnoses was low in controls without autoimmune diseases, while controls with diabetes showed a more pronounced increase in cardiovascular risk factors, but less in osteoporosis and cerebrovascular disease. Sensitivity analyses showed comparable results.ConclusionComorbidities are frequently detected at the time of diagnosis of SLE. High numbers of drug prescriptions and hospitalisation following SLE diagnosis reflect the comprehensive disease burden. The comparison with incident diabetes shows that differences with controls without autoimmune disease are overestimated by detection bias.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%