What are the implications for clinicians? It may be reasonable to re-evaluate the need for long-term PPIs among patients with difficult-to-manage CPPD.
The Study: Liew JW, Peloquin C, Tedeschi SK, et al. Proton pump inhibitors and risk of calcium pyrophosphate deposition in a population-based study. Arthritis Care Res (Hoboken). 2022 Mar 4. doi: 10.1002/acr.24876. Online ahead of print.
3) Disparities Persist
Race, ethnicity & disparities in the risk of end-organ lupus manifestations following SLE diagnosis
Why was this study done? Prior research has shown that many racial and ethnic groups in developed countries experience a disproportionate burden of systemic lupus erythematosus (SLE). We know less about the time course of severe SLE across organ domains by race and ethnicity.
What were the study methods? Adults with SLE in the California Lupus Epidemiology Study participated in annual study visits in which data on lupus manifestations were collected by a lupus expert. Self-reported race and ethnicity were categorized as non-Hispanic white, Hispanic, non-Hispanic Black and non-Hispanic Asian. Major end-organ lupus manifestations were categorized into the following organ systems: renal, hematologic, neurologic, cardiovascular, and pulmonary disease. Multi-organ disease was defined as manifestations in two or more of these distinct organ systems. Survival analysis methods were used to analyze the risk of end-organ manifestations following SLE diagnosis for Hispanic, Black and Asian participants compared with white participants, adjusting for sex and age at diagnosis.
What were the key findings? The racial and ethnic distribution of the cohort was 30% white, 23% Hispanic, 11% Black and 36% Asian. Renal and hematologic disease occurred early during the SLE disease course. Multi-organ disease was present in 29% of individuals with SLE; renal disease was concurrent in most cases of multi-organ disease. Hispanic and Asian participants with SLE had two- to threefold higher risks of renal, hematologic and multiorgan disease following diagnosis than white participants, adjusting for sex and age at diagnosis.
What are the main conclusions? In this study conducted in the U.S., we show that Hispanic and Asian individuals with SLE are at higher risk for developing renal, hematologic, and multiorgan manifestations of SLE than white individuals; in addition, Hispanic and Asian individuals develop these manifestations faster than white individuals. More than a quarter of participants had multi-organ involvement from SLE.
What are the implications for patients? People with SLE are encouraged to discuss their risk of lupus manifestations with their clinicians, and interventions that can ameliorate this risk.
