The Swiss Systemic lupus erythematosus Cohort Study (SSCS) - cross-sectional analysis of clinical characteristics and treatments across different medical disciplines in Switzerland

• Published in: Swiss medical weekly Vol. 144; no. 3132; p. w13990
• Main Authors: Ribi, Camillo, Trendelenburg, Marten, Gayet-Ageron, Angèle, Cohen, Clemens, Dayer, Eric, Eisenberger, Ute, Hauser, Thomas, Hunziker, Thomas, Leimgruber, Annette, Lindner, Gregor, Koenig, Katrin, Otto, Petra, Spertini, François, Stoll, Thomas, Von Kempis, Johannes, Chizzolini, Carlo
• Format: Journal Article
• Language: English
• Published: Switzerland SMW supporting association (Trägerverein Swiss Medical Weekly SMW) 07.08.2014
• Subjects: activity; Adolescent; Adrenal Cortex Hormones - therapeutic use; Adult; Age of Onset; Aged; Aged, 80 and over; Allergy and Immunology - statistics & numerical data; Antimalarials - therapeutic use; Blood Sedimentation; Child; Cross-Sectional Studies; Drug Prescriptions - statistics & numerical data; Drug Therapy, Combination - statistics & numerical data; Female; Humans; hydroxychloroquine; Immunosuppressive Agents - therapeutic use; Internal Medicine - statistics & numerical data; Kidney Diseases - complications; Lupus; Lupus Erythematosus, Systemic - blood; Lupus Erythematosus, Systemic - diagnosis; Lupus Erythematosus, Systemic - drug therapy; Lupus Erythematosus, Systemic - epidemiology; Male; Middle Aged; Nephrology - statistics & numerical data; Practice Patterns, Physicians' - statistics & numerical data; Propensity Score; Rheumatology - statistics & numerical data; Severity of Illness Index; Switzerland; Treatment; Young Adult; Switzerland
• ISSN: 1424-7860; 1424-3997
• DOI: 10.4414/smw.2014.13990

To describe disease characteristics and treatment modalities in a multidisciplinary cohort of systemic lupus erythematosus (SLE) patients in Switzerland. Cross-sectional analysis of 255 patients included in the Swiss SLE Cohort and coming from centres specialised in Clinical Immunology, Internal Medicine, Nephrology and Rheumatology. Clinical data were collected with a standardised form. Disease activity was assessed using the Safety of Estrogens in Lupus Erythematosus National Assessment-SLE Disease Activity Index (SELENA-SLEDAI), an integer physician's global assessment score (PGA) ranging from 0 (inactive) to 3 (very active disease) and the erythrocyte sedimentation rate (ESR). The relationship between SLE treatment and activity was assessed by propensity score methods using a mixed-effect logistic regression with a random effect on the contributing centre. Of the 255 patients, 82% were women and 82% were of European ancestry. The mean age at enrolment was 44.8 years and the median SLE duration was 5.2 years. Patients from Rheumatology had a significantly later disease onset. Renal disease was reported in 44% of patients. PGA showed active disease in 49% of patients, median SLEDAI was 4 and median ESR was 14 millimetre/first hour. Prescription rates of anti-malarial drugs ranged from 3% by nephrologists to 76% by rheumatologists. Patients regularly using anti-malarial drugs had significantly lower SELENA-SLEDAI scores and ESR values. In our cohort, patients in Rheumatology had a significantly later SLE onset than those in Nephrology. Anti-malarial drugs were mostly prescribed by rheumatologists and internists and less frequently by nephrologists, and appeared to be associated with less active SLE.