Examinando por Autor "McGwin, G. Jr."

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  • Miniatura
    ÍtemAcceso Abierto
    Disease features and outcomes in United States lupus patients of Hispanic origin and their Mestizo counterparts in Latin America: a commentary
    (Oxford University Press, 2016) Ugarte-Gil, M.F.; Pons-Estel, G.J.; Molineros, J.; Wojdyla, D.; McGwin, G. Jr.; Nath, S.K.; Pons-Estel, B.A.; Alarcón-Riquelme, M.; Alarcón, G.S.
    Objective. To evaluate disease features and outcomes in two populations with significant Amerindian ancestry. Methods. Hispanic patients (from Texas) from the Lupus in Minorities: Nature versus Nurture (LUMINA) cohort and Mestizo patients from the Grupo Latino Americano De Estudio del Lupus or Latin American Group for the Study of Lupus (GLADEL) cohort were included. Disease features and outcomes were evaluated at baseline and last visit. Admixture informative markers of Mestizo Genoma de Lupus Eritematoso Sistémico Network consortium (GENLES) patients and Hispanic LUMINA patients were compared. Univariable analyses were performed using Chi square or Student's t test as appropriate. Multivariable analyses adjusting for possible confounders were carried out using Poisson, logistic or Cox regression models as appropriate. Results. A total of 114 LUMINA and 619 GLADEL patients were included. GLADEL patients had accrued more damage at baseline, but the opposite was the case at last visit. Being from LUMINA was a risk factor for damage accrual, even after adjusting for possible confounders [relative risk (RR) 1.33, 95% CI 1.12, 1.58]. Also, LUMINA patients have a higher risk of mortality than GLADEL patients [hazard ratio (HR) 2.37, 95% CI 1.10, 5.15], having 5-year survival of 85.6% and 94.5%, respectively. In addition, 79 LUMINA patients and 744 Mestizo GENLES patients were evaluated in order to compare genetic ancestry between the two groups; GENLES patients had a higher proportion of European ancestry (48.5% vs 43.3%, P = 0.003) and a lower proportion of Asian ancestry (3.7% vs 4.9%, P = 0.048), but the proportions of Amerindian and African ancestry were comparable in both. Conclusion. USA Hispanic patients seemed to have a poorer prognosis than their counterparts from Latin America, despite having a comparable genetic background. Socioeconomic factors may account for these observations. © The Author 2014.
  • Miniatura
    ÍtemAcceso Abierto
    The number of flares patients experience impacts on damage accrual in systemic lupus erythematosus: Data from a multiethnic Latin American cohort
    (BMJ Publishing Group, 2015) Ugarte-Gil, M.F.; Acevedo-Vásquez, E.; Alarcón, G.S.; Pastor-Asurza, C.A.; Alfaro-Lozano, J.L.; Cucho-Venegas, J.M.; Segami, M.I.; Wojdyla, D.; Soriano, E.R.; Drenkard, C.; Brenol, J.C.; De Oliveira E Silva Montandon, A.C.; Lavras Costallat, L.T.; Massardo, L.; Molina-Restrepo, J.F.; Guibert-Toledano, M.; Silveira, L.H.; Amigo, M.C.; Barile-Fabris, L.A.; Chacón-Díaz, R.; Esteva-Spinetti, M.H.; Pons-Estel, G.J.; McGwin, G. Jr.; Pons-Estel, B.A.
    Purpose: To determine the association between the number of flares systemic lupus erythematosus (SLE) patients experience and damage accrual, independently of other known risk factors. Methods: SLE patients (34 centres, nine Latin American countries) with a recent diagnosis (≤2 years) and ≥3 evaluations were studied. Disease activity was ascertained with the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and damage with the SLICC/ACR Damage Index (SDI). Flare was defined as an increase ≥4 points in the SLEDAI between two study visits. An ambidirectional case- crossover design was used to determine the association between the number of flares and damage accrual. Results: 901 patients were eligible for the study; 500 of them (55.5%) experienced at least one flare, being the mean number of flares 0.9 (SD: 1.0). 574 intervals from 251 patients were included in the case-crossover design since they have case and control intervals, whereas, the remaining patients did not. Their mean age at diagnosis was 27.9 years (SD: 11.1), 213 (84.9%) were women. The mean baseline SDI and SLEDAI were 1.3 (1.3) and 13.6 (8.1), respectively. Other features were comparable to those of the entire sample. After adjusting for possible confounding variables, the number of flares, regardless of their severity, was associated with damage accrual (SDI) OR 2.05, 95% CI 1.43 to 2.94, p<0.001 (OR 2.62, 95% CI 1.31 to 5.24, p=0.006 for severe and OR 1.91, 95% CI 1.28 to 2.83, p=0.001 for mild-moderate). Conclusions: The number of flares patients experience, regardless of their severity, increases the risk of damage accrual, independently of other known risk factors. © 2015, BMJ Publishing Group. All rights reserved.