en
Scientific article
Open access
English

Glucocorticoids prescribing practices in systemic sclerosis: an analysis of the EUSTAR database

Published inRheumatology, keac533
First online date2022-09-13
Abstract

Objectives: To estimate the long-term exposure to glucocorticoids (GC), the factors associated with, and the variations in prescribing practices over time and across recruiting countries.

Methods: We included patients with systemic sclerosis (SSc) having a visit in the EUSTAR database from January 2013 onward. We analyzed the prevalence and the main features of GC users, the exposure to GC over time, and the respective dosages. Multivariable linear regression analysis identified factors associated with GC intake duration. Time trends, and variations in GC utilization across recruiting countries were explored. Missing data were imputed using multiple imputation with chained equations.

Results: The 9819 patients included were mostly females (85%), the majority had lcSSc (73%), and the median age was 58 years. At baseline, 34% of patients (n = 2769/8109) (48% dcSSc vs 29% lcSSc) were on GCs, and the median dose was 7.5 mg/day. GCs users were more frequently males and anti-Scl70 positive, and more commonly had dcSSc and more severe disease. On average, GCs users spent 25% of their follow-up time (median 33.2 months) on GCs, with no significant between-subsets difference. Notably, 33% (n = 971/2959) and 22% (n = 647/2959) of patients followed up for >1 year had received GCs for >6 and >12 months, respectively. Multivariable analysis showed that patient and disease characteristics poorly explained the variability in GCs exposure (adjusted-R2 = 0.06, P < 0.001). GCs utilization varied within and across countries, and gradually decreased over time (36% in 2013 vs 23% in 2018).

Conclusions: GC are widely and long-term prescribed in SSc, with significant between- and within-country(ies) differences. A gradual decrease in their utilization is observed.

eng
Keywords
  • Epidemiology
  • Glucocorticoids
  • Systemic sclerosis
Citation (ISO format)
IUDICI, Michèle et al. Glucocorticoids prescribing practices in systemic sclerosis: an analysis of the EUSTAR database. In: Rheumatology, 2022, p. keac533. doi: 10.1093/rheumatology/keac533
Main files (1)
Article (Accepted version)
accessLevelPublic
Secondary files (1)
Identifiers
ISSN of the journal1462-0324
112views
26downloads

Technical informations

Creation09/21/2022 11:48:00 AM
First validation09/21/2022 11:48:00 AM
Update time03/16/2023 8:02:33 AM
Status update03/16/2023 8:02:32 AM
Last indexation02/01/2024 8:59:59 AM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack