Publications by authors named "Chak-sing Lau"

Objective: High disease activity status (HDAS) in patients with systemic lupus erythematosus (SLE) is associated with adverse long-term outcomes. We examined the frequency of lupus low disease activity state (LLDAS) and remission (REM) attainment in HDAS patients and whether their attainment was associated with improved patient outcomes.

Methods: Demographic, clinical and outcomes data, collected prospectively from a multinational cohort between 2013 and 2020, were analysed.

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  • This study analyzed COVID-19 patients from a Hong Kong health database to differentiate severe and non-severe cases, focusing on age-specific outcomes and clinical parameters.* -
  • Researchers categorized patients into age groups (≤ 40, 41-64, and ≥ 65 years) and further stratified them based on their COVID-19 exposure severity, which included critically, severely, mildly-moderately exposed, and unexposed groups.* -
  • The findings revealed that as COVID-19 severity increased, so did the risks for various health issues, particularly in older adults, highlighting the importance of age in disease outcome assessments.*
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  • The lupus low disease activity state (LLDAS) allows some activity in systemic lupus erythematosus (SLE) as long as it stays within certain limits; this study examined the outcomes of patients achieving LLDAS with different levels of activity.
  • A total of 2,099 SLE patients were analyzed over a median follow-up of 3.5 years, revealing that 20.8% had clinical activity, 50.4% had serological activity only, and 28.8% had neither while in LLDAS.
  • Results indicated that all LLDAS subsets reduced the risk of disease flares and damage, with LLDAS showing no activity being the most protective against severe flares.
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Background: Basophil activation tests (BATs) are useful in identifying culprits of perioperative anaphylaxis (PA), but their utility remains limited due to technical limitations, cost, and availability. Being able to prioritize patients with likely higher yields for BAT would be useful in reducing costs and manpower.

Objective: We sought to investigate whether tryptase levels and clinical parameters may be useful for selecting patients for BATs.

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  • A study found that for rheumatoid arthritis patients who didn't respond to methotrexate, starting treatment with biosimilar DMARDs (like biosimilar infliximab) resulted in better clinical outcomes than conventional DMARDs, but cost-effectiveness data is still uncertain.
  • The aim was to assess the cost-effectiveness of starting biosimilar DMARD treatment after methotrexate failure compared to leflunomide, utilizing a Markov model to simulate long-term disease progression and costs based on local patient data from Hong Kong.
  • The analysis revealed that treating with leflunomide resulted in higher lifetime healthcare costs and fewer quality-adjusted life-years (QALYs) than bios
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Background: Immunocompromised individuals are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and subsequent severe or fatal coronavirus disease 2019 (COVID-19), yet they have suboptimal responses to mRNA and inactivated COVID-19 vaccines. The efficacy of tixagevimab-cilgavimab in reducing symptomatic SARS-CoV-2 infection was demonstrated in phase III clinical trials. Nevertheless, real-world data on the effectiveness and safety of tixagevimab-cilgavimab remain limited.

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Objectives: To evaluate the difference between BNT162b2 and CoronaVac in vaccine effectiveness and safety.

Methods: This target trial emulation study included individuals aged ≥12 during 2022. Propensity score matching was applied to ensure group balance.

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Background: Validation of protective associations of the lupus low disease activity state (LLDAS) against flare, irreversible damage, health-related quality of life, and mortality has enabled the adoption of treat-to-target strategies in patients with systemic lupus erythematosus (SLE). Previous validation studies were of short duration, limiting the ability to detect longer term signals in flare rate and irreversible damage. In addition, previous studies have focused on percent time at target, rather than actual periods of time that are more useful in clinical practice and trials.

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  • This study looked at how standard medications for systemic lupus erythematosus (SLE) affect important health outcomes like disease activity, flare-ups, and damage over time, using a substantial patient data set from the Asia Pacific Lupus Collaboration (APLC).
  • Findings showed that a significant percentage of patients reached low disease activity levels, but many also had flares, with variations in medication use across different countries; specifically, some medications appeared to have a steroid-sparing effect.
  • Key results revealed that patients on specific medications like tacrolimus had better odds of achieving low disease activity, while those taking azathioprine and methotrexate were less likely to reach that outcome; however
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Lupus erythematosus (LE) is a heterogeneous, antibody-mediated autoimmune disease. Isolate discoid LE (IDLE) and systematic LE (SLE) are traditionally regarded as the two ends of the spectrum, ranging from skin-limited damage to life-threatening multi-organ involvement. Both belong to LE, but IDLE and SLE differ in appearance of skin lesions, autoantibody panels, pathological changes, treatments, and immunopathogenesis.

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Lupus remains a disease with a low prioritisation in the national agendas of many countries in Latin America, the Middle East, and Asia-Pacific, where there is a dearth of rheumatologists and limited access to new or even standard lupus treatments. There is thus an important need for education, advocacy, and outreach to prioritise lupus in these regions to ensure that patients receive the care they need. This article reviews some of the specific challenges facing the care and management of people with lupus in these regions and suggests strategies for improving patient outcomes.

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  • The study aimed to determine if achieving Lupus Low Disease Activity State (LLDAS) leads to better outcomes for patients with newly diagnosed systemic lupus erythematosus (SLE).
  • Data was collected from a longitudinal SLE cohort in 13 countries, focusing on patients diagnosed within the last year, revealing that these patients had higher disease activity and use of glucocorticoids, but less organ damage initially compared to older patients in the study.
  • Results showed that while fewer patients in the recent onset group were in LLDAS at the start, they were more likely to achieve it during follow-up and LLDAS attainment was linked to a lower risk of disease flare-ups.
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  • * Data from a large international cohort of 1,850 mSACQ patients revealed that reducing GCs by 1 mg/day did not increase the risk of overall or severe flares; in fact, the use of antimalarials was linked to a lower risk of flares.
  • * Tapering GCs was found to reduce the risk of damage accrual for patients starting with higher prednisolone doses (over 5 mg/day
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The persisting risk of long-term health consequences of SARS-CoV-2 infection and the protection against such risk conferred by COVID-19 vaccination remains unclear. Here we conducted a retrospective territory-wide cohort study on 1,175,277 patients with SARS-CoV-2 infection stratified by their vaccination status and non-infected controls to evaluate the risk of clinical sequelae, cardiovascular and all-cause mortality using a territory-wide public healthcare database with population-based vaccination records in Hong Kong. A progressive reduction in risk of all-cause mortality was observed over one year between patients with SARS-CoV-2 infection and controls.

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Background: Targets of treatment for systemic lupus erythematosus (SLE) include the Lupus Low Disease Activity State (LLDAS), remission, and complete remission. Whether treatment can be tapered after attaining these targets and whether tapering is safer in patients in complete remission compared with LLDAS are unknown. We aimed to assess the odds of disease flares after treatment tapering in stable disease, versus continuing the same therapy.

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Background: Inborn errors of immunity (IEI) often lack specific disease models and personalized management. Signal transducer and activator of transcription (STAT)-1 gain of function (GoF) is such example of an IEI with diverse clinical phenotype with unclear pathomechanisms and unpredictable response to therapy. Limitations in obtaining fresh samples for functional testing and research further highlights the need for patient-specific ex vivo platforms.

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Background: Molnupiravir and nirmatrelvir-ritonavir have emerged as promising options for COVID-19 treatment, but direct comparisons of their effectiveness have been limited. This study aimed to compare the effectiveness of these two oral antiviral drugs in non-hospitalised and hospitalised patients with COVID-19.

Methods: In this target trial emulation study, we used data from a territory-wide electronic health records database on eligible patients aged ≥18 years infected with COVID-19 who were prescribed either molnupiravir or nirmatrelvir-ritonavir within five days of infection between 16 March 2022 and 31 December 2022 in the non-hospitalised and hospitalised settings in Hong Kong.

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It is unknown if vaccination affects the risk of post-COVID-19 cardiovascular diseases (CVDs). Therefore, this retrospective cohort study examines the short-term and long-term risks of post-infection CVD among COVID-19 patients with different vaccination status utilizing data from electronic health databases in Hong Kong. Cox proportional hazards regression adjusted with inverse probability of treatment weighting is used to evaluate the risks of incident CVD (coronary heart disease, stroke, heart failure) and all-cause mortality in COVID-19 patients.

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Background: Case reports suggest that SARS-CoV-2 infection could lead to immune dysregulation and trigger autoimmunity while COVID-19 vaccination is effective against severe COVID-19 outcomes. We aim to examine the association between COVID-19 and development of autoimmune diseases (ADs), and the potential protective effect of COVID-19 vaccination on such an association.

Methods: A retrospective cohort study was conducted in Hong Kong between 1 April 2020 and 15 November 2022.

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Our skin is the largest organ of the body and the foremost defensive barrier against the external environment [...

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It is challenging to manage inflammatory diseases using traditional anti-inflammatory drugs due to their limited efficacy and systemic side effects, which are a result of their lack of selectivity, poor stability, and low solubility. Herein, it reports the development of a novel nanoparticle system, called ROS-CA-NPs, which is formed using polymer-cinnamaldehyde (CA) conjugates and is responsive to reactive oxygen species (ROS). ROS-CA-NPs exhibit excellent drug stability, tissue selectivity, and controlled drug release upon oxidative stress activation.

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Objectives: Lupus nephritis (LN) remains one of the most severe manifestations in patients with systemic lupus erythematosus (SLE). Onset and overall LN risk among SLE patients remains considerably difficult to predict. Utilizing a territory-wide longitudinal cohort of over 10 years serial follow-up data, we developed and validated a risk stratification strategy to predict LN risk among Chinese SLE patients - Risk and Factors associated with disease manifestations in systemic Lupus Erythematosus - Lupus Nephritis (RIFLE-LN).

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Introduction: Evidence on long-term associations between coronavirus disease 2019 (COVID-19) and risks of multi-organ complications and mortality in older population is limited. This study evaluates these associations.

Research Design And Methods: The cohorts included patients aged ≥60 year diagnosed with COVID-19 infection (cases), between 16 March 2020 and 31 May 2021 from the UK Biobank; and between 01 April 2020 and 31 May 2022 from the electronic health records in Hong Kong.

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  • This study compared the cardiovascular safety of three types of medications: interleukin-6 inhibitors (IL-6i), Janus Kinase inhibitors (JAKi), and tumour necrosis factor inhibitors (TNFi), in patients with rheumatoid arthritis (RA).
  • Researchers analyzed data from Hong Kong, Taiwan, and Korea, focusing on newly diagnosed RA patients who started treatment with these drugs, tracking their health outcomes over time.
  • The results showed no significant difference in the risk of cardiovascular events between patients taking IL-6i or JAKi compared to those taking TNFi, indicating similar safety profiles for these treatments across all three countries.
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