Publications by authors named "Caroline Gordon"

Objectives: Cutaneous vasculitis (CV) is common in SLE, but the epidemiology and risk factors remain unclear. We aimed to identify the trends and risk factors for CV in patients with SLE over a period of 20 years.

Methods: The Birmingham Lupus Cohort is an observational longitudinal cohort of SLE patients.

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Background: Neuropsychiatric symptoms in SLE and other systemic autoimmune rheumatic diseases (SARDs) are challenging to diagnose, attribute and manage. We investigated the timings of onset of a broad range of neuropsychiatric (NP) symptoms in relation to timing of SLE onset. In addition, we explored whether NP symptoms may be a prodrome to SARD onset and to subsequent flares.

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  • The Manhattan Lupus Surveillance Program (MLSP) investigated cardiovascular disease events in systemic lupus erythematosus (SLE) patients and compared their rates to population controls based on sex, age, and race/ethnicity.
  • In a study of 1,285 SLE patients, 13.9% experienced cardiovascular events, with higher risks associated with being male and over the age of 60.
  • The study found that Hispanic/Latino and non-Hispanic Black patients had significantly elevated risks for cardiovascular events compared to other racial groups, highlighting a higher overall prevalence of these events among SLE patients compared to the general population.
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Objectives: This study aims to determine the independent impact of definitions of remission/low disease activity (LDA) on direct/indirect costs (DCs, ICs) in a multicentre inception cohort.

Methods: Patients from 31 centres in 10 countries were enrolled within 15 months of diagnosis and assessed annually. Five mutually exclusive disease activity states (DAS) were defined as (1) remission off-treatment: clinical (c) SLEDAI-2K=0, without prednisone/immunosuppressants; (2) remission on-treatment: cSLEDAI-2K=0, prednisone ≤5 mg/day and/or maintenance immunosuppressants; (3) LDA-Toronto Cohort (TC): cSLEDAI-2K≤2, without prednisone/immunosuppressants; (4) modified lupus LDA state (mLLDAS): SLEDAI-2K≤4, no activity in major organs/systems, no new activity, prednisone ≤7.

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Objective: Trauma history is associated with SLE onset and worse patient-reported outcomes; perceived stress is associated with greater SLE disease activity. Stress perceptions vary in response to life events and may be influenced by psychosocial factors. In an SLE cohort, we examined whether stressful events associated with perceived stress, whether psychosocial factors affected perceived stress, and whether these relationships varied by prior trauma exposure.

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  • Cranial neuropathies (CN) are a rare manifestation of neuropsychiatric lupus, and the study investigates the association of anti-KIF20B antibodies as a possible biomarker for this condition within a large cohort of SLE patients.
  • The research involved 795 patients from a larger cohort, revealing that 29.8% were positive for anti-KIF20B, with a significantly higher positivity rate (70%) in those with CN compared to those without (29.3%).
  • Findings suggest that anti-KIF20B positivity is linked to CN in SLE patients, indicating its potential as a biomarker, though further research is required to confirm these results.
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Objective: Attribution of neuropsychiatric symptoms in systemic lupus erythematosus (SLE) relies heavily on clinician assessment. Limited clinic time, variable knowledge, and symptom under-reporting contributes to discordance between clinician assessments and patient symptoms. We obtained attributional data directly from patients and clinicians in order to estimate and compare potential levels of direct attribution to SLE of multiple neuropsychiatric symptoms using different patient-derived measures.

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  • The study utilized the Manhattan Lupus Surveillance Program (MLSP) to analyze the prevalence of systemic lupus erythematosus (SLE) along with related rheumatic diseases like Sjögren's disease, antiphospholipid syndrome, and fibromyalgia among different demographics.
  • A total of 1,342 SLE patients were examined, with findings indicating that Sjögren's disease (11.0%) and antiphospholipid syndrome (8.9%) were notably common among Latino and Asian patients, while fibromyalgia also affected 8.9% of patients, particularly among non-Latino White and Latino populations.
  • The research revealed significant differences in autoantibody profiles associated with S
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Objectives: Outcomes of therapy for LN are often suboptimal. Guidelines offer varied options for treatment of LN and treatment strategies may differ between clinicians and regions. We aimed to assess variations in the usual practice of UK physicians who treat LN.

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Background: Social determinants of health are consistently associated with systemic lupus erythematosus (SLE) outcomes. However, social determinants of health are typically measured with conventional socioeconomic status factors such as income or education. We assessed the association of economic insecurities (ie, food, housing, health care, and financial insecurity) with patient-reported outcomes in a cohort of patients with SLE.

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Objective: Neuropsychiatric lupus (NPSLE) is challenging to diagnose. Many neuropsychiatric symptoms, such as headache and hallucinations, cannot be verified by tests or clinician assessment. We investigated prioritisations of methods for diagnosing NPSLE and attributional views.

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Background: Environmental factors can influence epigenetic regulation, including DNA methylation, potentially contributing to systemic lupus erythematosus (SLE) development and progression. We compared methylation of the B cell costimulatory CD70 gene, in persons with lupus and controls, and characterized associations with age.

Results: In 297 adults with SLE and 92 controls from the Michigan Lupus Epidemiology and Surveillance (MILES) Cohort, average CD70 methylation of CD4 T cell DNA across 10 CpG sites based on pyrosequencing of the promoter region was higher for persons with SLE compared to controls, accounting for covariates [β = 2.

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  • The study explores a broader range of neuropsychiatric symptoms in patients with systemic autoimmune rheumatic diseases (SARDs), finding that self-reported symptoms are significantly more common in these patients compared to controls.
  • Researchers conducted comparisons between patients, clinicians, and a control group, using mixed methods to analyze 30 different neuropsychiatric symptoms and their prevalence in a large patient sample.
  • The findings reveal a substantial gap between patients’ self-reports of mental health issues and clinicians’ assessments, highlighting barriers to symptom identification such as lack of communication and misunderstanding of symptom visibility.
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Background: We aimed to identify factors associated with a significant reduction in SLE disease activity over 12 months assessed by the BILAG Index.

Methods: In an international SLE cohort, we studied patients from their 'inception enrolment' visit. We also defined an 'active disease' cohort of patients who had active disease similar to that needed for enrolment into clinical trials.

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Objective: The goals of this study were to assess the associations of severe nonadherence to hydroxychloroquine (HCQ), objectively assessed by HCQ serum levels, and risks of systemic lupus erythematosus (SLE) flares, damage, and mortality rates over five years of follow-up.

Methods: The Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort is an international multicenter initiative (33 centers throughout 11 countries). The serum of patients prescribed HCQ for at least three months at enrollment were analyzed.

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Objectives: Medication access and adherence play key roles in determining patient outcomes. We investigated whether cost-related non-adherence (CRNA) to prescription medications was associated with worse patient-reported outcomes in a population-based systemic lupus erythematosus (SLE) cohort.

Methods: Sociodemographic and prescription data were collected by structured interviews in 2014-2015 from patients meeting SLE criteria in the established Michigan Lupus Epidemiology & Surveillance (MILES) Cohort.

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Objectives: A novel longitudinal clustering technique was applied to comprehensive autoantibody data from a large, well-characterised, multinational inception systemic lupus erythematosus (SLE) cohort to determine profiles predictive of clinical outcomes.

Methods: Demographic, clinical and serological data from 805 patients with SLE obtained within 15 months of diagnosis and at 3-year and 5-year follow-up were included. For each visit, sera were assessed for 29 antinuclear antibodies (ANA) immunofluorescence patterns and 20 autoantibodies.

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Background: Systemic lupus erythematosus (SLE) is a complex autoimmune disease associated with widespread immune dysregulation and diverse clinical features. Immune abnormalities might be differentially associated with specific organ involvement or response to targeted therapies. We aimed to identify biomarkers of response to belimumab after rituximab to facilitate a personalised approach to therapy.

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Objective: To estimate direct and indirect costs associated with neuropsychiatric (NP) events in the Systemic Lupus International Collaborating Clinics inception cohort.

Methods: NP events were documented annually using American College of Rheumatology definitions for NP events and attributed to systemic lupus erythematosus (SLE) or non-SLE causes. Patients were stratified into 1 of 3 NP states (no, resolved, or new/ongoing NP event).

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Objectives: Patients with Systemic Lupus Erythematosus are known to have dysregulated immune responses and may have reduced response to vaccination against COVID-19 while being at risk of severe COVID-19 disease. The aim of this study was to identify whether vaccine responses were attenuated in SLE and to assess disease- and treatment-specific associations.

Methods: Patients with SLE were matched by age, sex and ethnic background to healthcare worker healthy controls (HC).

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  • The study aims to provide statistics on the prevalence and incidence of Mixed Connective Tissue Disease (MCTD) by using data from the Manhattan Lupus Surveillance Program (MLSP), which includes diverse populations with systemic lupus erythematosus (SLE) and related diseases.
  • MCTD cases were identified through rheumatology, hospitals, and databases, with specific criteria established for diagnosis, including positive RNP antibodies and certain clinical symptoms.
  • Results showed that the prevalence of MCTD varied significantly depending on the diagnostic criteria used, with the highest age-adjusted prevalence being 16.22 per 100,000 people, highlighting the complexities of defining MCTD in epidemiological research.
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