{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:29:40Z","timestamp":1787311780208,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,1,27]],"date-time":"2017-01-27T00:00:00Z","timestamp":1485475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Goeff Carr Lupus Fellowship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The phenotype of patients who remain naive of glucocorticosteroids has not been described, and the type and rate of their damage accrual remains largely unknown. The objective of this study was to compare the type, amount, rate, and nature of organ damage accrual, mortality, and atherosclerotic comorbidities in glucocorticosteroid\u2010naive and glucocorticosteroid\u2010exposed patients with systemic lupus erythematosus (SLE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Inception patients from the University of Toronto Lupus Clinic who had never taken glucocorticosteroids and had a minimum of 3 years of followup were compared to patients who received glucocorticosteroids within the first 6 months of SLE diagnosis and for at least 3 years. All patients had no damage at inception.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 86 glucocorticosteroid\u2010naive and 173 glucocorticosteroid\u2010exposed patients were included. There were more females and whites among the glucocorticosteroid\u2010naive patients, whereas the glucocorticosteroid\u2010exposed patients had higher Systemic Lupus Erythematosus Disease Activity Index 2000 scores on first examination. Overall mortality was higher in the glucocorticosteroid\u2010exposed group, but the deaths occurred late. There was no difference in the frequency of coronary artery disease overall or at each of the time points. Damage accrual was higher in glucocorticosteroid\u2010exposed patients overall and at 5 and 8 years. Individual damage items that were higher in glucocorticosteroid\u2010exposed patients included ocular (cataracts) and musculoskeletal (osteoporosis with fragility fractures, and osteonecrosis) components.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mortality is more frequent in patients taking glucocorticosteroids for at least the first 3 years of their lupus compared to patients who are glucocorticosteroid\u2010naive. In addition, patients taking glucocorticosteroids accumulate more damage by 5 years of disease, and damage tends to be glucocorticosteroid related, including cataracts and musculoskeletal components.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.22938","type":"journal-article","created":{"date-parts":[[2016,5,24]],"date-time":"2016-05-24T06:48:16Z","timestamp":1464072496000},"page":"252-256","source":"Crossref","is-referenced-by-count":21,"title":["Disease Outcomes in Glucocorticosteroid\u2010Naive Patients With Systemic Lupus Erythematosus"],"prefix":"10.1002","volume":"69","author":[{"given":"Barry J.","family":"Sheane","sequence":"first","affiliation":[{"name":"University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dafna D.","family":"Gladman","sequence":"additional","affiliation":[{"name":"University of Toronto and Toronto Western Hospital Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiandong","family":"Su","sequence":"additional","affiliation":[{"name":"University of Toronto and Toronto Western Hospital Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murray B.","family":"Urowitz","sequence":"additional","affiliation":[{"name":"University of Toronto and Toronto Western Hospital Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,1,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.080214"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.120572"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34672"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.080912"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200008)43:8<1801::AID-ANR16>3.0.CO;2-O"},{"key":"e_1_2_6_7_1","first-page":"1955","article-title":"Accrual of organ damage over time in patients with systemic lupus erythematosus","volume":"30","author":"Gladman DD","year":"2003","journal-title":"J Rheumatol"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21039"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kei079"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2005.01.008"},{"key":"e_1_2_6_11_1","first-page":"288","article-title":"Systemic Lupus Erythematosus Disease Activity Index 2000","volume":"29","author":"Gladman DD","year":"2002","journal-title":"J Rheumatol"},{"key":"e_1_2_6_12_1","first-page":"1977","article-title":"Summarizing disease features over time: I. Adjusted mean SLEDAI derivation and application to an index of disease activity in lupus","volume":"30","author":"Ibanez D","year":"2003","journal-title":"J Rheumatol"},{"key":"e_1_2_6_13_1","first-page":"336","article-title":"Summarizing disease features over time: II. Variability measures of SLEDAI\u20102K","volume":"34","author":"Ibanez D","year":"2007","journal-title":"J Rheumatol"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780390303"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22299"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.068676"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203306071872"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-205171"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facr.22938","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facr.22938","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.22938","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T14:59:33Z","timestamp":1759417173000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.22938"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,27]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,2]]}},"alternative-id":["10.1002\/acr.22938"],"URL":"https:\/\/doi.org\/10.1002\/acr.22938","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1,27]]}}}