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Aversa Z, White TA, Heeren AA, Hulshizer CA, Saul D, Zhang X, Molina AJA, Redman LM, Martin CK, Racette SB, Huffman KM, Bhapkar M, Khosla S, Das SK, Fielding RA, Atkinson EJ, LeBrasseur NK. Calorie restriction reduces biomarkers of cellular senescence in humans. Aging Cell 2024; 23:e14038. [PMID: 37961856 PMCID: PMC10861196 DOI: 10.1111/acel.14038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023] Open
Abstract
Calorie restriction (CR) with adequate nutrient intake is a potential geroprotective intervention. To advance this concept in humans, we tested the hypothesis that moderate CR in healthy young-to-middle-aged individuals would reduce circulating biomarkers of cellular senescence, a fundamental mechanism of aging and aging-related conditions. Using plasma specimens from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE™) phase 2 study, we found that CR significantly reduced the concentrations of several senescence biomarkers at 12 and 24 months compared to an ad libitum diet. Using machine learning, changes in biomarker concentrations emerged as important predictors of the change in HOMA-IR and insulin sensitivity index at 12 and 24 months, and the change in resting metabolic rate residual at 12 months. Finally, using adipose tissue RNA-sequencing data from a subset of participants, we observed a significant reduction in a senescence-focused gene set in response to CR at both 12 and 24 months compared to baseline. Our results advance the understanding of the effects of CR in humans and further support a link between cellular senescence and metabolic health.
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Affiliation(s)
- Zaira Aversa
- Robert and Arlene Kogod Center on Aging, Mayo ClinicRochesterMinnesotaUSA
- Department of Physical Medicine and RehabilitationMayo ClinicRochesterMinnesotaUSA
| | - Thomas A. White
- Robert and Arlene Kogod Center on Aging, Mayo ClinicRochesterMinnesotaUSA
| | - Amanda A. Heeren
- Robert and Arlene Kogod Center on Aging, Mayo ClinicRochesterMinnesotaUSA
| | | | - Dominik Saul
- Robert and Arlene Kogod Center on Aging, Mayo ClinicRochesterMinnesotaUSA
- Department of Trauma and Reconstructive SurgeryEberhard Karls University Tübingen, BG Trauma Center TübingenTübingenGermany
| | - Xu Zhang
- Robert and Arlene Kogod Center on Aging, Mayo ClinicRochesterMinnesotaUSA
| | | | | | - Corby K. Martin
- Pennington Biomedical Research CenterBaton RougeLouisianaUSA
| | - Susan B. Racette
- College of Health SolutionsArizona State UniversityPhoenixArizonaUSA
- Program in Physical TherapyWashington University School of MedicineSt. LouisMissouriUSA
| | - Kim M. Huffman
- Duke Clinical Research Institute and Molecular Physiology Institute, School of MedicineDurhamNorth CarolinaUSA
| | - Manjushri Bhapkar
- Duke Clinical Research Institute and Molecular Physiology Institute, School of MedicineDurhamNorth CarolinaUSA
| | - Sundeep Khosla
- Robert and Arlene Kogod Center on Aging, Mayo ClinicRochesterMinnesotaUSA
- Division of EndocrinologyMayo Clinic College of MedicineRochesterMinnesotaUSA
| | - Sai Krupa Das
- Energy Metabolism Team, Jean Mayer USDA Human Nutrition Research Center on AgingTufts UniversityBostonMassachusettsUSA
| | - Roger A. Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on AgingTufts UniversityBostonMassachusettsUSA
| | | | - Nathan K. LeBrasseur
- Robert and Arlene Kogod Center on Aging, Mayo ClinicRochesterMinnesotaUSA
- Department of Physical Medicine and RehabilitationMayo ClinicRochesterMinnesotaUSA
- Paul F. Glenn Center for the Biology of Aging at Mayo ClinicRochesterMinnesotaUSA
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Karmacharya P, Chakradhar R, Hulshizer CA, Gunderson TM, Ogdie A, Davis JM, Wright K, Tollefson MM, Duarte-García A, Bekele D, Maradit-Kremers H, Crowson CS. Multimorbidity in Psoriasis as a Risk Factor for Psoriatic Arthritis: A Population-Based Study. Rheumatology (Oxford) 2024:keae040. [PMID: 38291896 DOI: 10.1093/rheumatology/keae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVES To examine multimorbidity in psoriasis and its association with the development of PsA. METHODS A retrospective cohort study was performed using the Rochester Epidemiology Project. Population-based incidence (2000-2009) and prevalence (Jan 1, 2010) cohorts of psoriasis were identified by manual chart review. A cohort of individuals without psoriasis (comparators) were identified (1:1 matched on age, sex, and county). Morbidities were defined using ≥2 Clinical Classification Software codes ≥30 days apart within prior five years. PsA was defined using ClASsification of Psoriatic ARthritis (CASPAR) criteria. χ2 and rank-sum tests were used to compare morbidities, and age-, sex-, and race-adjusted Cox models to examine the association of baseline morbidities in psoriasis with development of PsA. RESULTS Among 817 incident psoriasis patients, the mean age was 45.2 years with 52.0% females, and 82.0% moderate/severe psoriasis. No multimorbidity differences were found between incident psoriasis patients and comparators. However, in the 1,088 prevalent psoriasis patients, multimorbidity was significantly more common compared with 1,086 comparators (OR : 1.35 and OR : 1.48 for ≥2 and ≥5 morbidities, respectively). Over a median 13.3-year follow-up, 23 patients (cumulative incidence: 2.9% by 15 years) developed PsA. Multimorbidity (≥2 morbidities) was associated with a 3-fold higher risk of developing PsA. CONCLUSION Multimorbidity was more common in the prevalent but not incident cohort of psoriasis compared with the general population, suggesting patients with psoriasis may experience accelerated development of multimorbidity. Moreover, multimorbidity at psoriasis onset significantly increased the risk of developing PsA, highlighting the importance of monitoring multimorbid psoriasis patients for the development of PsA.
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Affiliation(s)
- Paras Karmacharya
- Division of Rheumatology & Immunology, Vanderbilt University Medical Center, Nashville, TN
- Division of Rheumatology, Mayo Clinic, Rochester, MN
| | - Rikesh Chakradhar
- Division of Rheumatology, Mayo Clinic, Rochester, MN
- Department of Psychiatry, MetroHealth Medical Center, Psychiatry, Cleveland, OH
| | | | - Tina M Gunderson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Alexis Ogdie
- Departments of Medicine/Rheumatology and Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - John M Davis
- Division of Rheumatology, Mayo Clinic, Rochester, MN
| | - Kerry Wright
- Division of Rheumatology, Mayo Clinic, Rochester, MN
| | - Megha M Tollefson
- Departments of Dermatology and Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Alí Duarte-García
- Division of Rheumatology, Mayo Clinic, Rochester, MN
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Delamo Bekele
- Division of Rheumatology, Mayo Clinic, Rochester, MN
| | | | - Cynthia S Crowson
- Division of Rheumatology, Mayo Clinic, Rochester, MN
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
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Figueroa-Parra G, Meade-Aguilar JA, Hulshizer CA, Gunderson TM, Chamberlain AM, Thanarajasingam U, Greenlund KJ, Barbour KE, Crowson CS, Duarte-García A. Multimorbidity in systemic lupus erythematosus in a population-based cohort: the lupus Midwest network. Rheumatology (Oxford) 2023:kead617. [PMID: 38001025 DOI: 10.1093/rheumatology/kead617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVES To assess the prevalence and incidence of multimorbidity and the association with the SLICC/ACR damage index (SDI) among patients with systemic lupus erythematosus (SLE). METHODS Using prevalent and incident population-based cohorts of patients with SLE and their matched comparators, we assessed 57 chronic conditions. Chronic conditions were categorized as SDI-related or SDI-unrelated. Multimorbidity was defined as the presence of 2+ chronic conditions. Multimorbidity at prevalence and incidence/index was compared between cohorts using logistic regression. Cox models were used to examine development of multimorbidity after SLE incidence. RESULTS The prevalent cohort included 449 patients with established SLE on January 1, 2015. They were three times more likely to have multimorbidity compared with non-SLE comparators (OR 2.98, 95% CI 2.18-4.11). The incident cohort included 270 patients with new-onset SLE. At SLE incidence, patients with SLE were more likely to have multimorbidity than comparators (OR 2.27, 95% CI 1.59-3.27). After incidence, the risk of developing multimorbidity was 2-fold higher among patients with SLE than comparators (hazard ratio (HR) 2.11, 95% CI 1.59-2.80). Development of multimorbidity was higher in patients with SLE based on SDI-related (HR 2.91, 95% CI 2.17-3.88) and SDI-unrelated conditions (HR 1.73, 95% CI, 1.32-2.26). CONCLUSION Patients with SLE have a higher burden of multimorbidity, even before the onset of the disease. The risk disparity continues after SLE classification and is also seen in a prevalent SLE cohort. Multimorbidity is driven both by SDI-related and unrelated conditions.
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Affiliation(s)
| | | | | | - Tina M Gunderson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Alanna M Chamberlain
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Kurt J Greenlund
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kamil E Barbour
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cynthia S Crowson
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Alí Duarte-García
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
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Montes D, Hulshizer CA, Myasoedova E, Davis JM, Hanson AC, Duarte-Garcia A, Figueroa-Parra G, Chevet B, Crowson CS. Utilisation of cardiovascular preventive services in a rheumatoid arthritis population-based cohort. RMD Open 2023; 9:e003318. [PMID: 37945289 PMCID: PMC10649903 DOI: 10.1136/rmdopen-2023-003318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/10/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVES The objective is to examine utilisation of cardiovascular preventive services in patients with rheumatoid arthritis (RA), compared with a non-RA population, and to examine cardiovascular disease (CVD) screening rates among RA patients without diabetes mellitus (DM), hypertension or hyperlipidaemia to non-RA patients with one of these diagnoses. METHODS All ≥18-year-old patients with an RA diagnosis living in one of eight Minnesota counties on 1 January 2015 were included and matched (1:1) by sex, age and county to non-RA comparators. Rates of screening for CVD risk factors, including DM (ie, glucose), hypertension (ie, blood pressure) and hyperlipidaemia (ie, lipids), were compared between groups using Cox models. RESULTS The study included 1614 patients with RA and 1599 non-RA comparators. DM screening was more common among patients with RA (HR: 1.10, 95% CI: 1.01 to 1.19), as was hypertension screening (HR: 1.37, 95% CI: 1.24 to 1.52). Hyperlipidaemia screening in RA was similar to comparators (HR: 0.99, 95% CI: 0.89 to 1.10). Conversely, patients with RA and no CVD risk factors had a lower probability of undergoing diabetes (HR: 0.67, 95% CI: 0.57 to 0.78) and hyperlipidaemia screening (HR: 0.65, 95% CI: 0.54 to 0.79) than non-RA patients with only one CVD risk factor diagnosis. Hypertension screening was similar between both groups. CONCLUSIONS RA patients undergo CVD preventive screening at rates at least comparable to the general population. However, patients with RA as their sole CVD risk factor were less likely to undergo screenings, despite an equivalent-to-higher risk as the traditional CVD risk factors. These findings demonstrate opportunities for improvement of RA patient care.
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Affiliation(s)
- Daniel Montes
- Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Elena Myasoedova
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA
| | - John M Davis
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Andrew C Hanson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Baptiste Chevet
- Spécialité de Rhumatologie, Centre Hospitalier Universitaire de Brest, Brest, France
| | - Cynthia S Crowson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA
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Larsen RA, Constantopoulos E, Kodishala C, Lovering E, Kumar R, Hulshizer CA, Lennon RJ, Crowson CS, Nguyen AT, Myasoedova E. Neuropathologic evaluation of cerebrovascular disease in patients with rheumatoid arthritis. Rheumatology (Oxford) 2023; 62:SI296-SI303. [PMID: 37871918 PMCID: PMC10593511 DOI: 10.1093/rheumatology/kead396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/19/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVES Active RA has been associated with an increased risk of both cardiovascular and peripheral vascular disease. We aimed to compare cerebrovascular changes in patients with and without RA, both with and without a neuropathologic diagnosis of neurodegenerative disease. METHODS Patients with RA (n = 32) who died and underwent autopsy between 1994 and 2021 were matched to non-RA controls (n = 32) on age, sex and level of neurodegenerative proteinopathy. Routine neuropathologic examination was performed at the time of autopsy. Cerebrovascular disease severity was evaluated using modified Kalaria and Strozyk scales. Clinical dementia diagnoses were manually collected from patients' medical records. RESULTS Prior to death, 15 (47%) RA patients and 14 (44%) controls were diagnosed with dementia; 9 patients in each group (60% and 64%, respectively) had Alzheimer's disease. The prevalence of cerebral amyloid angiopathy, microinfarcts, infarcts or strokes was found to be similar between groups. Patients with RA were more likely to have more severe vascular changes in the basal ganglia by Kalaria scale (P = 0.04), but not in other brain areas. There were no significant differences in the presence of large infarcts, lacunar infarcts or leukoencephalopathy by Strozyk scale. Among patients with RA and no clinical diagnosis of dementia, the majority had mild-moderate cerebrovascular abnormalities, and a subset of patients had Alzheimer's disease neuropathologic changes. CONCLUSION In this small series of autopsies, patients with and without RA had largely similar cerebrovascular pathology when controlling for neurodegenerative proteinopathies, although patients with RA exhibited more pronounced cerebrovascular disease in the basal ganglia.
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Affiliation(s)
- Rachel A Larsen
- Department of Laboratory Medicine and Pathology, Neuropathology Mayo Clinic, Rochester, MN, USA
| | - Eleni Constantopoulos
- Department of Laboratory Medicine and Pathology, Neuropathology Mayo Clinic, Rochester, MN, USA
| | - Chanakya Kodishala
- Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Edward Lovering
- Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Rakesh Kumar
- Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Ryan J Lennon
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Cynthia S Crowson
- Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Aivi T Nguyen
- Department of Laboratory Medicine and Pathology, Neuropathology Mayo Clinic, Rochester, MN, USA
| | - Elena Myasoedova
- Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
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Kodishala C, Hulshizer CA, Kronzer VL, Davis JM, Ramanan VK, Vassilaki M, Mielke MM, Crowson CS, Myasoedova E. Dr. Kodishala et al reply. J Rheumatol 2023; 50:853. [PMID: 36379572 DOI: 10.3899/jrheum.221021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - John M Davis
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota
| | | | - Maria Vassilaki
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Michelle M Mielke
- Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Cynthia S Crowson
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Elena Myasoedova
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota;
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
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Kodishala C, Hulshizer CA, Kronzer VL, Davis JM, Ramanan VK, Vassilaki M, Mielke MM, Crowson CS, Myasoedova E. Risk Factors for Dementia in Patients With Incident Rheumatoid Arthritis: A Population-Based Cohort Study. J Rheumatol 2023; 50:48-55. [PMID: 35840149 PMCID: PMC9812854 DOI: 10.3899/jrheum.220200] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Growing evidence suggests that patients with rheumatoid arthritis (RA) have increased risk for dementia. We assessed risk factors for incident dementia in an inception cohort of patients with RA. METHODS This retrospective population-based cohort study included residents of 8 counties in Minnesota who were ≥ 50 years of age when they met 1987 American College of Rheumatology criteria for incident RA between 1980 and 2014 and were followed until death/migration or December 31, 2019. Patients with dementia before RA incidence were excluded. Incident dementia was defined as 2 relevant International Classification of Diseases, 9th or 10th revision codes at least 30 days apart. Data on sociodemographics, disease characteristics, cardiovascular/cerebrovascular disease (CVD) risk factors, and comorbidities were abstracted from medical records. RESULTS The study included 886 patients with RA (mean age 65.1 yrs, 65.2% female). During the follow-up period (median 8.5 yrs), 103 patients developed dementia. After adjusting for age, sex, and calendar year of RA incidence, older age at RA incidence (HR 1.14 per 1 year increase, 95% CI 1.12-1.17), rheumatoid nodules (HR 1.76, 95% CI 1.05-2.95), hypertension (HR 1.84, 95% CI 1.19-2.85), presence of large joint swelling (HR 2.03, 95% CI 1.14-3.60), any CVD (HR 2.25, 95% CI 1.38-3.66), particularly ischemic stroke (HR 3.16, 95% CI 1.84-5.43) and heart failure (HR 1.82, 95% CI 1.10-3.00), anxiety (HR 1.86, 95% CI 1.16-2.97), and depression (HR 2.63, 95% CI 1.76-3.93) were associated with increased risk of dementia. After adjusting for CVD risk factors and any CVD, all covariates listed above were still significantly associated with risk of dementia. CONCLUSION Apart from age, hypertension, depression, and anxiety, all of which are universally recognized risk factors for dementia, clinically active RA and presence of CVD were associated with an elevated risk of dementia incidence among patients with RA.
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Affiliation(s)
- Chanakya Kodishala
- C. Kodishala, MBBS, DM, V.L. Kronzer, MD, MSCI, J.M. Davis III, MD, Division of Rheumatology, Mayo Clinic
| | | | - Vanessa L Kronzer
- C. Kodishala, MBBS, DM, V.L. Kronzer, MD, MSCI, J.M. Davis III, MD, Division of Rheumatology, Mayo Clinic
| | - John M Davis
- C. Kodishala, MBBS, DM, V.L. Kronzer, MD, MSCI, J.M. Davis III, MD, Division of Rheumatology, Mayo Clinic
| | | | - Maria Vassilaki
- M. Vassilaki, MD, PhD, Department of Quantitative Health Sciences, Mayo Clinic
| | - Michelle M Mielke
- M.M. Mielke, PhD, Department of Quantitative Health Sciences, Department of Neurology, Mayo Clinic
| | - Cynthia S Crowson
- C.S. Crowson, PhD, Division of Rheumatology, Department of Quantitative Health Sciences, Mayo Clinic
| | - Elena Myasoedova
- E. Myasoedova, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
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Chevet B, Figueroa-Parra G, Yang JX, Hulshizer CA, Gunderson TM, Duong SQ, Putman MS, Barbour KE, Crowson CS, Duarte-García A. COVID-19 Vaccine Uptake Among Patients With Systemic Lupus Erythematosus in the American Midwest: The Lupus Midwest Network (LUMEN). J Rheumatol 2022; 49:1276-1282. [PMID: 35777817 PMCID: PMC9633343 DOI: 10.3899/jrheum.220220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Patients with systemic lupus erythematosus (SLE) are at higher risk of poor outcomes from coronavirus disease 2019 (COVID-19). The vaccination rate among such patients is unknown. We aimed to assess COVID-19 vaccine uptake among patients with SLE. METHODS We included 342 patients with SLE from the Lupus Midwest Network (LUMEN) and 350 age-, sex-, race-, and county-matched comparators. Vaccination uptake for influenza, pneumococcal, and zoster vaccines before pandemic restrictions began (up to February 29, 2020) was assessed. First-dose COVID-19 vaccine uptake was electronically retrieved and manually ascertained (December 15, 2020, to July 31, 2021). Time to COVID-19 vaccination, demographics, SLE manifestations, medications, Charlson Comorbidity Index, Area Deprivation Index, and Rural-Urban Commuting Area codes were compared. RESULTS On July 31, 2021, 83.3% of patients with SLE and 85.5% of comparators were vaccinated against COVID-19. The COVID-19 vaccination rates were similar among SLE and comparators (hazard ratio 0.93, 95% CI 0.79-1.10). Unvaccinated patients with SLE were more likely than vaccinated patients to be men (27.3% vs 14.1%), younger (mean age 54.1 vs 58.8 yrs), have a shorter SLE duration (median 7.3 vs 10.7 yrs), and be less frequently vaccinated with influenza and pneumococcal vaccines. CONCLUSION Patients with SLE in the Lupus Midwest Network had similar COVID-19 vaccination uptake as matched comparators, most of whom were vaccinated early when the vaccine became available. One in 6 patients with SLE remain unvaccinated.
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Affiliation(s)
- Baptiste Chevet
- B. Chevet, MD, Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA, and Division of Rheumatology, Brest Teaching Hospital, LBAI, UMR1227, Univ Brest, Inserm, CHU de Brest, Brest, France
| | | | - Jeffrey X Yang
- J.X. Yang, MD, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Cassondra A Hulshizer
- C.A. Hulshizer, BA, T.M. Gunderson, MS, S.Q. Duong, MS, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Tina M Gunderson
- C.A. Hulshizer, BA, T.M. Gunderson, MS, S.Q. Duong, MS, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Stephanie Q Duong
- C.A. Hulshizer, BA, T.M. Gunderson, MS, S.Q. Duong, MS, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael S Putman
- M.S. Putman, MD, MSci, Division of Rheumatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Kamil E Barbour
- K.E. Barbour, PhD, MPH, MS, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cynthia S Crowson
- C.S. Crowson, PhD, Division of Rheumatology, and Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Alí Duarte-García
- A. Duarte-García, MD, MSc, Division of Rheumatology, and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.
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Chevet B, Figueroa-Parra G, Yang JX, Hocaoglu M, Osei-Onomah SA, Hulshizer CA, Gunderson TM, Cornec D, Barbour KE, Greenlund KJ, Crowson CS, Duarte-García A. Utilization of preventive services in a systemic lupus erythematosus population-based cohort: a Lupus Midwest Network (LUMEN) study. Arthritis Res Ther 2022; 24:211. [PMID: 36050780 PMCID: PMC9434086 DOI: 10.1186/s13075-022-02878-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 07/24/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is a disease that can lead to damage of multiple organs and, along with certain treatments, increase the risk of developing cancer, cardiovascular disease, diabetes, osteoporosis, and infections. Preventive services are particularly important in patients with SLE to mitigate the aforementioned risks. We aimed to evaluate the trends of preventive services utilization in patients with systemic lupus erythematosus, compared with non-SLE population. METHODS All ≥19-year-old patients in the Lupus Midwest Network (LUMEN) registry, a population-based cohort, with SLE on January 1, 2015, were included and matched (1:1) by sex, age, race, and county to non-SLE comparators. Among both groups, we compared the rates of screenings for breast and cervical cancer, hypertension, hyperlipidemia, diabetes mellitus, and osteoporosis as well as immunizations. RESULTS We included 440 SLE patients and 430 non-SLE comparators. The probability of breast cancer screening among women with SLE was similar to comparators (hazard ratio [HR] 1.09, 95% CI 0.85-1.39), while cervical cancer screening was lower (HR 0.75, 95% CI 0.58-0.96). Hypertension screening was higher among patients with SLE (HR 1.35, 95% CI 1.13-1.62); however, hyperlipidemia screening was similar to comparators (HR 1.16, 95% CI 0.96-1.41). Diabetes and osteoporosis screenings were more likely to be performed for SLE patients than for comparators (HR 2.46, 95% CI 2.11-2.87; and HR 3.19, 95% CI 2.31-4.41; respectively). Influenza and pneumococcal immunizations were higher among SLE patients (HR 1.31, 95% CI 1.12-1.54; and HR 2.06, 95% CI 1.38-3.09; respectively), while zoster vaccination was similar (HR 1.17, 95% CI 0.81-1.69). CONCLUSIONS The trends of utilization of preventive services by SLE patients vary according to screening or vaccine compared with the general population. Considering these differences, we demonstrate an opportunity for improvement, particularly in cervical cancer, hyperlipidemia, and osteoporosis screenings and vaccinations.
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Affiliation(s)
- Baptiste Chevet
- Division of Rheumatology, Mayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA
- Division of Rheumatology, Brest Teaching Hospital; LBAI, UMR1227, Univ Brest, Inserm, CHU de Brest, Brest, France
| | | | - Jeffrey X Yang
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mehmet Hocaoglu
- Division of Rheumatology, Mayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA
| | | | | | - Tina M Gunderson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Divi Cornec
- Division of Rheumatology, Brest Teaching Hospital; LBAI, UMR1227, Univ Brest, Inserm, CHU de Brest, Brest, France
| | - Kamil E Barbour
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kurt J Greenlund
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Cynthia S Crowson
- Division of Rheumatology, Mayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Alí Duarte-García
- Division of Rheumatology, Mayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA.
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
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