Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Sex Differences in Healthcare Utilization in LN

Arthritis Rheumatol; ePub 2017 Nov 28; Feldman, et al

In an incident lupus nephritis (LN) cohort (n=2,750), end-stage renal disease (ESRD) and mortality were extremely high overall, but not increased among males compared to females, a recent study found. Therefore, in this vulnerable population, biologic and healthcare utilization differences by sex may not significantly affect outcomes. Within Medicaid Analytic eXtract (MAX) from 29 states (2000-2010), researchers used billing claims to identify individuals aged 5 to 65 years with incident LN. MAX data were linked to the US Renal Data System to determine ESRD, and to Social Security Death Index files to determine death. They found:

  • Of total patients with incident LN, 283 (10%) were male.
  • Mean follow-up was 3.1 (SD 2.3); mean age was 25 (SD 14) years among males; 30 (SD 14) among females.
  • Males had fewer outpatient and emergency department visits.
  • The 5-year cumulative incidence of ESRD was 22.3% in males, 21.2% in females, and of death, 9.4% in males, 9.8% in females.
  • There were no sex differences in ESRD or death.

Citation:

Feldman CH, Broder A, Guan H, Yazdany J, Costenbader KH. Sex differences in healthcare utilization, end-stage renal disease and mortality among Medicaid beneficiaries with incident lupus nephritis. [Published online ahead of print November 28, 2017]. Arthritis Rheumatol. doi:10.1002/art.40392.

This Week's Must Reads

Hyperlipidemia Screening Poor in Persons with RA, Rheumatology (Oxford); ePub 2018 Jun 27; Schmidt, et al

Patient Confusion About Global Assessment for RA, Arthritis Care Res; ePub 2018 Jun 28; Hirsh, et al

Shared Decision-Making in RA at Point-of-Care, Arthritis Care Res; ePub 2018 Jun 28; Hsiao, et al

Examining Adiponectin Role in Rheumatoid Arthritis, PLoS One; ePub 2018 Jun 25; Hughes-Austin, et al

Online Resources for Disease Self-Management in RA, Clin Rheumatol; 2018 Jul; des Bordes, Gonzalez, et al

Must Reads in Lupus & Connective Tissue Diseases

Infections Most Common in SSc Hospitalizations, Rheumatology (Oxford); ePub 2018 Jun 2; Poudel, et al

Autonomic Dysfunction Common in Systemic Sclerosis, J Rheumatol; ePub 2018 Jun 15; Adler, Russell, et al

Lack of Sleep, Transition to SLE, May Be Linked, Lupus; ePub 2018 May 28; Young, Munroe, et al

Remission, Low Disease Activity Compared in SLE, Arthritis Rheumatol; ePub 2018 May 27; Petri, et al

Effects of Poverty and Neighborhood Stress on SLE, Arthritis Care Res; ePub 2018 May 21; Yelin, et al