BEGIN:VCALENDAR
VERSION:2.0
PRODID:-//Talks.cam//talks.cam.ac.uk//
X-WR-CALNAME:Talks.cam
BEGIN:VEVENT
SUMMARY:The Natural History and Predictive Factors of Long Term Outcomes i
 n Systemic Lupus Erythematosus:  Analysis from the Hopkins Lupus Cohort - 
 Penny Watson\, School of Health and Related Research\, The University of S
 heffield
DTSTART:20110614T133000Z
DTEND:20110614T143000Z
UID:TALK30835@talks.cam.ac.uk
CONTACT:Li Su
DESCRIPTION:Introduction\n\nDecision makers across the world use evidence 
 of treatment benefit from different sources to decide the coverage of new 
 treatments. There is a pipeline of new treatments for SLE in clinical tria
 ls and recently completed Phase III trials. Therefore\, there is a need fo
 r data to inform longer term effectiveness and cost-effectiveness analyses
  in SLE for decision-making.\n\nObjective\n\nTo develop a natural history 
 model to simulate long-term outcomes in Systemic Lupus Erythematosus (SLE)
 .\n\nMethods\n\nLongitudinal data on 1354 patients from the Hopkins Lupus 
 Cohort were included in the analysis. Disease activity\, treatments\, Syst
 emic Lupus International Collaborative Clinics/American College of Rheumat
 ology Damage Index (SLICC/ACR DI) events\, and laboratory tests are report
 ed at every clinic visit. A linear random effects model was used to estima
 te mean change in SLE Disease Activity Index (SLEDAI) score over a year an
 d to estimate average prednisone dose as a function of SLEDAI score. Param
 etric survival models were used to estimate organ damage and mortality. A 
 simulation model combined the separate statistical models to assess the va
 lidity of the natural history predictions.\n\nResults\n\nThe long-term dis
 ease activity model finds that previous SLEDAI\, previous renal involvemen
 t\, age\, and males predict a reduction in future SLEDAI score. Ethnicity\
 , anaemia\, haematological involvement\, increased DNA binding and low com
 plement in the previous year predict an increase in disease activity. The 
 annual average prednisone dose increases for every unit increase in annual
  average SLEDAI. Adjusted Mean SLEDAI was associated with an increased ris
 k of mortality\, cardiovascular\, renal and peripheral vascular damage. Or
 gan involvement predicted mortality\, cardiovascular\, renal\, neuropsychi
 atric\, pulmonary\, gastrointestinal\, ocular and skin damage. Corticoster
 oids increase the risk of gonadal failure\, diabetes\, cardiovascular\, mu
 sculoskeletal\, neuropsychiatric\, and gastrointestinal damage. The simula
 tion reproduces some of the patient outcomes reported in the Hopkins Lupus
  cohort with good accuracy.\n\nConclusion\n\nThe analysis generates a natu
 ral history model that can be used to extrapolate the long-term effectiven
 ess and cost-effectiveness of treatments for SLE. Alternative modelling me
 thods should be explored to improve the description of long term outcomes 
 for future treatment assessments\n
LOCATION:Large Seminar Room\, 1st Floor\, Institute of Public Health\, Uni
 versity Forvie Site\, Robinson Way\, Cambridge
END:VEVENT
END:VCALENDAR