HEALTH: Harnessing Epidemiology to Advance Lupus Treatment and Health

健康：利用流行病学促进狼疮治疗和健康

• 批准号: 10668437
• 负责人: Jill P Buyon
• 金额: $ 90万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2027-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10668437
• 关键词: HEALTH; Harnessing; Epidemiology; Advance; Lupus

ABSTRACT Lupus remains a leading cause of death in young women, with racial/ethnic minority patients having worse long-term outcomes, including progression to end stage renal disease and overall mortality, and poorer intermediate outcomes of disease activity and damage accrual. Further, manifestations of lupus affect physical function, fatigue, pain, and other patient-reported outcomes, potentially leading to challenges with maintaining everyday activities and function, which are linked to better quality of life, productivity, and survival. Finally, a major challenge in SLE management is delayed identification of early kidney disease, which ultimately leads to a greater burden on both patients and the health system. In response to the CDC NOFO RFA-DP-22-002, Component A, “Epidemiology of Lupus: Longitudinal Studies in Population-Based Cohorts,” this proposal leverages our well-established, longitudinal, ethnically/racially and socioeconomically diverse, and phenotypically well-characterized cohort of patients with lupus. This proposal’s overarching goals include clarifying the long-term natural history of SLE by evaluating disease severity, morbidity, and multi-morbidity; assessing disparities in illness experience associated with race/ethnicity, age, and socioeconomic status; collecting novel biospecimens to potentially differentiate roots of pain/fatigue syndromes; and evaluating a novel strategy to identify early kidney disease in high-risk patients. The NYU Lupus Cohort is a “living” biorepository with >900 patients enrolled, three-quarters followed at least twice annually, with diverse backgrounds (50% minority race; 30% Hispanic) and socioeconomic status (31% public hospital patients) who provide samples over time. Data include demographics, established classification criteria over time, medications, routine metabolic and hematologic parameters, laboratory-based urine analysis, autoantibody profiles, disease activity fluctuations and organ damage accrual using validated instruments, patient-reported outcomes, and measures for socioeconomic status and position, and material, behavioral, psychosocial, health system, and health outcomes. We propose to extend our longitudinal Cohort with linkage to electronic health records and state-wide, all-payer claims data for comorbidity data, new cytokine profiles and transcriptomic modules, and implementating a novel strategy to identify early kidney disease. Our multidisciplinary team will address three Specific Aims: 1) Quantify multimorbidity and major healthcare use in patients with lupus to improve understanding of lupus and non-lupus comorbidities, including disparities by sociodemographic factors; 2) Measure the burden of lupus on quality of life, with analyses to assess disparities by sociodemographic factors, behavioral and psychosocial factors, and genetic information; and 3) Develop and evaluate innovative, technology-driven home-based proteinuria testing for patients at elevated risk of nephritis. Overall, this study is anticipated to provide a significantly improved understanding of lupus epidemiology, including lupus-related morbidity and quality of life, and targets for interventions to manage patients with lupus.

抽象的 狼疮仍然是年轻女性死亡的主要原因，少数种族/族裔患者的情况更糟 长期结果，包括进展为终末期肾病和总体死亡率，以及较差 疾病活动和损害累积的中间结果。此外，狼疮的表现会影响身体 功能、疲劳、疼痛和其他患者报告的结果，可能会导致维持的挑战 日常活动和功能，与更好的生活质量、生产力和生存息息相关。最后，一个 SLE 管理的主要挑战是早期肾脏疾病的延迟识别，这最终导致 给患者和卫生系统带来更大的负担。响应 CDC NOFO RFA-DP-22-002， 组件 A，“狼疮流行病学：基于人群的队列纵向研究”，该提案 利用我们完善的、纵向的、民族/种族和社会经济多样性，以及 表型特征明确的狼疮患者队列。该提案的总体目标包括 通过评估疾病严重程度、发病率和多重发病率来阐明 SLE 的长期自然史； 评估与种族/族裔、年龄和社会经济地位相关的疾病经历差异； 收集新的生物样本以潜在地区分疼痛/疲劳综合征的根源；并评估一个 识别高危患者早期肾脏疾病的新策略。纽约大学狼疮队列是一个“活生生” 生物样本库招募了超过 900 名患者，其中四分之三每年至少接受两次随访， 背景（50% 少数族裔；30% 西班牙裔）和社会经济地位（31% 公立医院患者） 随着时间的推移提供样品。数据包括人口统计数据、随时间推移建立的分类标准、 药物、常规代谢和血液学参数、实验室尿液分析、自身抗体 使用经过验证的仪器、患者报告的概况、疾病活动波动和器官损伤累积 结果以及社会经济地位和地位以及物质、行为、心理、健康的衡量标准 系统和健康结果。我们建议扩大我们的纵向队列与电子健康的联系 记录和全州范围内的所有付款人索赔数据，包括合并症数据、新的细胞因子概况和转录组学 模块，并实施一种新的策略来识别早期肾脏疾病。我们的多学科团队将 解决三个具体目标：1) 量化狼疮患者的多重发病率和主要医疗保健使用情况，以 提高对狼疮和非狼疮合并症的了解，包括社会人口统计学差异 因素； 2) 衡量狼疮对生活质量的负担，通过分析评估差异 社会人口因素、行为和社会心理因素以及遗传信息； 3) 开发和 评估针对肾炎风险较高患者的创新、技术驱动的家庭蛋白尿检测。 总体而言，这项研究预计将显着提高对狼疮流行病学的理解， 包括狼疮相关的发病率和生活质量，以及管理狼疮患者的干预措施目标。

项目成果

Clinical and Serologic Phenotyping and Damage Indices in Patients With Systemic Lupus Erythematosus With and Without Fibromyalgia.

伴有或不伴有纤维肌痛的系统性红斑狼疮患者的临床和血清学表型及损伤指数。

• DOI: 10.1002/acr2.11641
• 发表时间: 2024
• 期刊: ACR open rheumatology
• 影响因子: 3.4
• 作者: Corbitt,Kelly;Carlucci,PhilipM;Cohen,Brooke;Masson,Mala;Saxena,Amit;Belmont,HMichael;Tseng,Chung-E;Barbour,KamilE;Gold,Heather;Buyon,Jill;Izmirly,Peter
• 通讯作者: Izmirly,Peter