Be vigilant for cardiovascular, renal, and infectious complications in African American patients with SLE.
Reference1. Barnado A, Carroll RJ, Casey C, et al. Phenome-wide association study identifies marked increased in burden of comorbidities in African Americans with systemic lupus erythematosus. Arthritis Res Ther. 2018;20:69. doi: 10.1186/s13075-018-1561-8.
Barnado and colleagues at Vanderbilt University in Nashville, TN, found that African Americans with systemic lupus erythematosus (SLE) have a greater burden of comorbidities than white patients with SLE.1
Thumb through the slide show for the details of this study and the take-home points for clinicians.
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It is estimated that African Americans have 3 times the risk of developing lupus compared with whites. In addition, African American women have a younger age of onset and higher rates of renal disease than white women.
The phenome-wide scan is a novel approach to examining longitudinal data in an EHR. It is similar to genome-wide association studies, which benefit from the ability to examine large sets of data and uncover subtle patterns.
CI, confidence interval; FDR, false discovery rate; OR, odds ratio.
Cardiovascular comorbidities included congestive heart failure (FDR p = 5.63 × 10−6), cerebrovascular disease (FDR p = 4.23 × 10−4), thromboembolism (FDR p = 4.47 × 10−4), peripheral vascular disease (FDR p = 0.04), coronary artery disease (FDR p = 0.04), and arrhythmias (FDR p = 0.04).
Significant renal codes included renal dialysis (OR = 10.90; 6.11 - 19.48; FDR p = 8.75 × 10−14), acute renal failure (FDR p = 1.05 × 10−11), chronic renal failure (FDR p = 7.08 × 10−10), and renal transplant (FDR p = 2.32 × 10−8).
The most common infection was pneumonia (OR = 3.57; 2.57 - 5.38; FDR p = 2.32 × 10−8) followed by cellulitis, pyelonephritis, and bacteremia.