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- Title
The association of trauma with self-reported flares and disease activity in systemic lupus erythematosus (SLE).
- Authors
Katz, Patricia; Patterson, Sarah L; DeQuattro, Kimberly; Lanata, Cristina M; Barbour, Kamil E; Greenlund, Kurt J; Gordon, Caroline; Criswell, Lindsey A; Dall'Era, Maria; Yazdany, Jinoos
- Abstract
Objectives Trauma has been linked to incident SLE, but its relationship with SLE disease activity is unknown. This analysis examines associations between trauma exposures and patient-reported SLE disease activity and flares. Methods Data were from the California Lupus Epidemiology Study (CLUES). Flares were self-reported as any flare and, of those, flares accompanied by medical care (hospitalization or physician contact). The Systemic Lupus Activity Questionnaire (SLAQ) assessed disease activity. The Brief Trauma Questionnaire (BTQ) assessed all historical trauma exposures. The Adverse Childhood Experiences (ACEs) questionnaire was available for a subset. Multivariable regression analyses (n = 252) examined whether trauma exposure was associated with flares or SLAQ controlling for age, sex, poverty, race/ethnicity, comorbidities, perceived stress, disease duration and self-reported disease damage. Results Excluding exposure to serious illness, 63.4% reported ≥1 trauma exposure. Any traumatic event, excluding illness, doubled the odds of a flare [OR 2.27 (95% CI 1.24, 4.17)] and was associated with significantly higher SLAQ scores [β 2.31 (0.86, 3.76)]. Adjusted odds of any flare and flare with medical care were significantly elevated for those with both BTQ and ACE exposures [5.91 (2.21, 15.82) and 4.69 (1.56, 14.07), respectively]. SLAQ scores were also higher for those with both exposures [β 5.22 (3.00, 7.44)]. Conclusion In this cohort, those with a history of trauma reported more flares and greater disease activity. Identifying mechanisms of associations between trauma and disease activity and flares, as well as interventions to mitigate the effects of trauma exposures is critical, given the high rates of trauma exposures.
- Subjects
CONFIDENCE intervals; SELF-evaluation; MULTIVARIATE analysis; MULTIPLE regression analysis; AGE distribution; RACE; SEX distribution; HOSPITAL care; QUESTIONNAIRES; DISEASE duration; RESEARCH funding; WOUNDS &; injuries; SYSTEMIC lupus erythematosus; POVERTY; ODDS ratio; COMORBIDITY; LONGITUDINAL method
- Publication
Rheumatology, 2023, Vol 62, Issue 8, p2780
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/keac690