Lupus & antiphospholipid syndrome
Risk of Bloodstream Infection in Patients with Systemic Lupus Erythematosus Exposed to Prolonged Medium-to-High-Dose Glucocorticoids
Authors' conclusion
In patients with SLE exposed to prolonged medium-to-high-dose glucocorticoids, the 1-year incidence rate of BSI was significantly higher than previously reported in the general patients with SLE. Severe disease activity, and high-dose glucocorticoid treatment previously or at baseline increased the risk of BSI.
Study context
- Population
- Patients with systemic lupus erythematosus (SLE) treated with prolonged (≥4 weeks) medium-to-high-dose GC (≥15 mg/day prednisolone), over 14 years
- Participants
- 612 patients1,109 treatment episodes
- Outcome
- 1-year incidence of BSI
- Follow-up
- 1 year
Methodological detailsgeneralized estimating equation, multivariable analysis
- Generalized estimating equation
- Multivariable analysis
Main finding
As reported in the abstract
Incidence rate of BSI
Bloodstream infection (BSI) cases during 1078.64 person-years
30
Incidence rate of BSI per 100 person-years
2.78
95% CI 1.88–3.97
Observational data: associations, not effects.
Further findings
| Outcome | Values | IRR (95% CI) | |
|---|---|---|---|
| Mortality, treatment episodes with BSIvs other episodes | Episodes with BSI 16.7% | 19.59 (7.33–52.44) | |
| 0.050.21520Incidence rate ratio (log scale) |
Risk factors for BSI (multivariable analysis)
| aIRR (95% CI) | ||
|---|---|---|
| SLEDAI-2K ≥20 | 4.66 (2.17–10.00) | |
| Initial baseline prednisolone ≥ 60 mg/day | 2.42 (1.11–5.32) | |
| Cumulative prednisolone dose ≥15 mg/day during previous 6 months | 2.13 (1.03–4.40) | |
| 0.10.31310Adjusted incidence rate ratio (log scale) |
- Higher incidence rate of BSI as disease activity or baseline GC dose increased
Original publication
Risk of Bloodstream Infection in Patients with Systemic Lupus Erythematosus Exposed to Prolonged Medium-to-High-Dose Glucocorticoids. Lupus. Published 1 March 2023. doi:10.
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