A Spatiotemporal Analysis of Organ‐Specific Lupus Flares in Relation to Atmospheric Variables and Fine Particulate Matter Pollution
Year: 2020
Type: article
Abstract: OBJECTIVE: To identify potential clusters of systemic lupus erythematosus (SLE) organ-specific flares and their relationship to fine particulate matter pollution (PM2.5), temperature, ozone concentration, resultant wind, relative humidity, and barometric pressure in the Hopkins Lupus Cohort, using spatiotemporal cluster analysis. METHODS: A total of 1,628 patients who fulfilled the Systemic Lupus International Collaborating Clinics classification criteria for SLE and who had a home address recorded were included in the analysis. Disease activity was assessed using the Lupus Activity Index. Assessment of rash, joint involvement, serositis, and neurologic, pulmonary, renal, and hematologic activity was quantified on a 0-3 visual analog scale (VAS). An organ-specific flare was defined as an increase in VAS of ≥1 point compared to the previous visit. Spatiotemporal clusters were detected using SaTScan software. Regression models were used for cluster adjustment and included individual, county-level, and environmental variables. RESULTS: Significant clusters unadjusted for environmental variables were identified for joint flares (P < 0.05; n = 3), rash flares (P < 0.05; n = 4), hematologic flares (P < 0.05; n = 3), neurologic flares (P < 0.05; n = 2), renal flares (P < 0.001; n = 4), serositis (P < 0.001; n = 2), and pulmonary flares (P < 0.001; n = 2). The majority of the clusters identified changed in significance, temporal extent, or spatial extent after adjustment for environmental variables. CONCLUSION: We describe the first spatiotemporal clusters of lupus organ-specific flares. Seasonal, as well as multi-year, cluster patterns were identified, differing in extent and location for the various organ-specific flare types. Further studies focusing on each individual organ-specific flare are needed to better understand the driving forces behind these observed changes.
Source: Arthritis & Rheumatology
DOI: 10.1002/art.41217
Institution: Johns Hopkins University
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: A SPATIAL TEMPORAL ANALYSIS OF ORGAN-SPECIFIC LUPUS FLARES IN RELATION TO ATMOSPHERIC AND ENVIRONMENTAL FACTOR...NEW GRANT, SIGNED ON 8/27/2019, DISTRIBUTED ON 8/27/2019, FAADC 8/28/2019, Characterizing the Spatial Temporal Dynamics and Human Health Risks of Vibrio parahaemolyticus Bacteria in Estuarine Environments, Institute for Clinical and Translational Research (UL1), G3593991805, G394505350, Hopkins Lupus Cohort, G524770891, Hopkins Lupus Cohort, Johns Hopkins Institute for Clinical and Translational Research, Johns Hopkins Rheumatic Diseases Resource-based Core Center (Johns Hopkins RDRCC)
OpenAlex ID: W3005237351