{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T06:32:02Z","timestamp":1791095522275,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008207","name":"AstraZeneca Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008207","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Our objective was to describe the administration of glucocorticoids (GCs) and characterize its association with organ damage in a longitudinal systemic lupus erythematosus (SLE) cohort over a time period spanning the introduction of biologics in Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective observational study was conducted using data from a large SLE cohort in Canada, including adults without lupus nephritis or central nervous system lupus. Patients were observed from time of entry into the cohort to the last available clinic visit (up to December 31, 2020), with a minimum of 24 months of follow\u2010up. Demographic and clinical characteristics, including average disease activity, treatment administration, and prevalence of organ damage, were examined. Organ damage was stratified by GC administration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,255 patients were included. The mean follow\u2010up duration was 10.5 (SD 8.6) years. One hundred eighty\u2010two (15%) patients had organ damage at baseline. More than 80% of patients were prescribed GCs over the follow\u2010up period, almost all patients had long\u2010term GC treatment, and only 5% of patients took any biologics. Organ damage was more frequent in patients with a higher average GC dose and greater years of GC exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this large cohort of patients with SLE, the majority of patients continue to rely on GC for SLE symptom management, with limited administration of biologics. GC administration was correlated with increased irreversible organ damage. Access to novel GC\u2010sparing treatment options is critical to improve long\u2010term outcomes for patients with SLE, especially given the continued reliance on GC despite the introduction of biologics.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr2.11680","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T02:19:45Z","timestamp":1719368385000},"page":"531-539","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Unfavorable Outcomes Associated With Glucocorticoid Use in Current <scp>Standard\u2010of\u2010Care<\/scp> Management of Systemic Lupus Erythematosus in Canada"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5177-2076","authenticated-orcid":false,"given":"Zahi","family":"Touma","sequence":"first","affiliation":[{"name":"Toronto Western Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheena","family":"Kayaniyil","sequence":"additional","affiliation":[{"name":"AstraZeneca  Mississauga Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Parackal","sequence":"additional","affiliation":[{"name":"AstraZeneca  Mississauga Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denisse","family":"Bonilla","sequence":"additional","affiliation":[{"name":"Toronto Western Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiandong","family":"Su","sequence":"additional","affiliation":[{"name":"Toronto Western Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Qian","sequence":"additional","affiliation":[{"name":"Broadstreet Health Economics &amp; Outcomes Research  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3649-2927","authenticated-orcid":false,"given":"Sally D.","family":"Miller","sequence":"additional","affiliation":[{"name":"Broadstreet Health Economics &amp; Outcomes Research  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Johnston","sequence":"additional","affiliation":[{"name":"Medical Decision Modeling Inc.  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