RT Journal Article
SR Electronic
T1 Medical Nonadherence, Cannabis Use, and Renal Outcome in Systemic Lupus Erythematosis
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 389973
DO 10.1101/389973
A1 Basmah A. Jalil
A1 Clifford R. Qualls
A1 Romy J. Cabacungan
A1 Wilmer L. Sibbitt, Jr
A1 James I. Gibb
A1 Leonard E. Noronha
A1 Roderick A. Fields
A1 N. Suzanne Emil
A1 Monthida Fangtham
A1 Arthur D Bankhurst
YR 2018
UL http://biorxiv.org/content/early/2018/08/15/389973.abstract
AB Background/Objective Non-adherence to recommended medical therapy has been associated with poorer outcomes in systemic lupus erythematosus (SLE). The present research investigated the association of medical non-adherence and cannabis use on renal outcomes of SLE.Methods This was a prospective 5-year longitudinal outcome study of 276 female SLE patients 30.4% who chronically used medical cannabis and 69.5% who did not. Outcomes were determined at 5 years after enrollment in the study.Results Cannabis use in SLE patients was associated with an increased prevalence of neuropsychiatric SLE (p<0.05), opioid analgesic use (p<0.01), cigarette smoking (p<0.001), and non-adherence to the medical regimen (non-cannabis: 3% non-adherence vs. cannabis use: 95% non-adherence, p<0.001). Within the 5-year period, the cannabis group demonstrated a 53% increase in mortality (p=0.12) and 127% increase in end-stage renal disease requiring dialysis (p<0.001). With logistic regression analysis adjusting for SLE disease activity (SLEDAI-2K), cannabis use was an independent predictor of end-stage renal disease: Odds ratio 2.65 (CI 1.32 – 5.32, p<0.01). Adjusting for SLE disease damage (SLICC/ACR-DI), cannabis use remained an independent predictor of end-stage renal disease: Odds ratio 2.0 (CI 1.26 – 6.23, p<0.01). With multivariable analysis adjusting for non-adherence, the effect of cannabis on end-stage renal disease could be largely attributed to an increase in non-adherence to medical therapy.Conclusions Non-adherence to recommended therapy and medical cannabis use are associated with a significant increase in the development of end-stage renal disease in SLE.