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Predictors of Premature Gonadal Failure in Patients with Systemic Lupus Erythematosus. Results from LUMINA, a Multiethnic US Cohort
  1. Luis A González (luis.gonzalez{at}ccc.uab.edu)
  1. The University of Alabama at Birmingham, United States
    1. Gerald McGwin, Jr (gerald.mcgwin{at}ccc.uab.edu)
    1. The University of Alabama at Birmingham, United States
      1. Sergio Durán (sergio.duranbarragan{at}ccc.uab.edu)
      1. The University of Alabama at Birmingham, United States
        1. Guillermo J Pons-Estel (gponsestel{at}hotmail.com)
        1. The University of Alabama at Birmingham, United States
          1. Mandar Apte (mandar.apte{at}ccc.uab.edu)
          1. The University of Alabama at Birmingham, United States
            1. Luis M Vilá (lvila{at}rcm.upr.edu)
            1. The University of Puerto Rico Medical Sciences Campus, Puerto Rico
              1. John D Reveille (john.d.reveille{at}uth.tmc.edu)
              1. The University of Texas Health Science Center at Houston, United States
                1. Graciela S Alarcón (graciela.alarcon{at}ccc.uab.edu)
                1. University of Alabama at Birmingham, United States

                  Abstract

                  Objective: To examine the predictors of time-to-premature gonadal failure (PGF) in SLE patients from LUMINA a multiethnic US cohort.

                  Methods: PGF was defined as per the SLICC Damage Index (SDI). Factors associated with time-to-PGF occurrence were assessed by univariable and multivariable [three models according to cyclophosphamide use, at T0 (model 1); over time (model 2); and the total number of intravenous pulses (model 3)] Cox proportional hazard regression analyses.

                  Results: Thirty-seven of 316 women (11.7%) developed PGF (19 Hispanic-Texans, 14 African Americans, 4 Caucasians and no Hispanic-Puerto Ricans). By multivariable analyses, older age at T0 (HR=1.10 to 1.14; 95% CI 1.01 to 1.05-1.19 to 1.23) and disease activity (SLAM-R) in all models (HR=1.22 to 1.24; 95% CI 1.10 to 1.12-1.35 to 1.37), Hispanic-Texan ethnicity in models 2 and 3 (HR=4.06 to 4.19; 95% CI 1.03 to 1.06-15.94 to 16.51) and cyclophosphamide use in models 1 and 3 (HR=2.47 to 4.01; 95% CI 1.09 to 1.68-5.6 to 9.56) were predictors of a shorter time-to-PGF.

                  Conclusions: Disease activity and Texan-Hispanic ethnicity, associations not previously reported, emerged as predictors of a shorter time-to-PGF while the associations with cyclophosphamide use and older age were confirmed.

                  • Gonadal
                  • SLE
                  • failure
                  • predictors
                  • premature

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