Risk-stratified monitoring for sulfasalazine toxicity: prognostic model development and validation
Authors' conclusion
This prognostic model for sulfasalazine toxicity uses readily available data and should be used to risk-stratify blood-test monitoring during established sulfasalazine treatment.
Study context
- Population
- UK primary care adults (≥18 years) with a new diagnosis of an inflammatory condition and a sulfasalazine prescription, 1 January 2007 to 31 December 2019Nine candidate predictors
- Participants
- 8,936 vs 5,203
- Exposure
- Development vs Validation
- Developmentn = 8,936
- Validationn = 5,203
- Outcome
- Sulfasalazine discontinuation with abnormal monitoring blood-test result
- Follow-up
- Followed up from 6 months after first prescription to up to 5 years
Methodological detailsprognostic model development and validation, independent development and validation cohorts, penalised Cox regression, multiple imputation
- Prognostic model development and validation
- Independent development and validation cohorts
- Penalised Cox regression
- Multiple imputation
Main finding
As reported in the abstract
Model performance
| Group | Value | Person-years | Optimism adjusted R2 D | Royston D statistic | Calibration slope (95% CI) | Royston D statistic (95% CI) |
|---|---|---|---|---|---|---|
| Development | 473 events | 23 299 | 0.13 | 0.79 | ||
| Validation | 280 events | 12 867 | 1.19 (0.96 to 1.43) | 0.87 (0.67 to 1.07) |
Value
Development473 events
Validation280 events
Person-years
Development23 299
Validation12 867
Optimism adjusted R2 D
Development0.13
Validation— not stated in the abstract
Royston D statistic
Development0.79
Validation— not stated in the abstract
Calibration slope (95% CI)
Development— not stated in the abstract
Validation1.19 (0.96 to 1.43)
Royston D statistic (95% CI)
Development— not stated in the abstract
Validation0.87 (0.67 to 1.07)
Observational data: associations, not effects.
Original publication
Risk-stratified monitoring for sulfasalazine toxicity: prognostic model development and validation. RMD Open. Published 7 March 2024. doi:10.
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