Lupus & antiphospholipid syndrome
Persistence of antimalarial therapy and its effect on mortality in systemic lupus erythematosus: A population-based longitudinal multistate study
Authors' conclusion
AM discontinuation is associated with higher mortality.
Study context
- Population
- All British Columbia residents with incident Systemic Lupus Erythematosus (SLE) who initiate Antimalarials (AM)
- Participants
- 7,399 incident SLE initiating AMs
- Exposure
- AM discontinuation vs AM persistence
- Outcome
- Transitions among AM persistence, discontinuation and death
Methodological detailsincident cohort, health administrative data, reversible frailty multistate Cox model
- Incident cohort
- Health administrative data
- Reversible frailty multistate Cox model
Main finding
As reported in the abstract
Transitions between persistence, discontinuation and death
- Time spent in persistence vs discontinuation
- half of follow-up time in each
- Persistence episodes ending in lapse to discontinuation
- 99.2%
- Discontinuation episodes resulting in return to persistence
- 64.5%
- Risk of an episode ending in death, discontinuation vs persistence
- over five times higher
Observational data: associations, not effects.
Further findings
Determinants of lapsing from persistence (HR)
- Rural residents
- 0.94
- Users of cardiovascular drugs
- 0.87
- Higher-income areas
- 0.93
- Alcohol-use disorder
- 1.47
Determinants of returning to persistence (HR)
- Older age
- 0.995
- Depression
- 0.92
- Higher comorbidity
- 0.97
- NSAID use
- 1.08
Determinants of death during persistence (HR)
- Older age, per year
- 1.06
- Rural residence
- 1.67
Determinants of death during discontinuation (HR)
- Men
- 1.55
- Older age, per year
- 1.09
- Greater outpatient use
- 1.014
- GC use
- 1.24
- Cardiovascular drugs
- 1.30
- Higher income (quintile 4)
- 0.63
Original publication
Persistence of antimalarial therapy and its effect on mortality in systemic lupus erythematosus: A population-based longitudinal multistate study. Lupus. Published 30 July 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →