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; 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的主要死亡原因，种族/少数民族患者的死亡率更糟 长期结局，包括发展为终结肾脏疾病和整体死亡率，较差 疾病活动和损害准确性的中间结果。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，有可能导致维持的挑战 日常活动和功能，与更好的生活质量，生产力和生存有关。最后，一个 SLE管理中的主要挑战是对早期肾脏疾病的延迟鉴定，最终导致 对患者和卫生系统的燃烧更大。响应CDC NOFO RFA-DP-22-002， 组成部分A，“狼疮的流行病学：基于人群的队列的纵向研究”，该提案 利用我们建立良好的，纵向，种族/种族和社会经济上的潜水 表型型狼疮患者的表现良好。该提议的总体目标包括 通过评估疾病的严重程度，发病率和多种疾病来阐明SLE的长期自然历史； 评估与种族/种族，年龄和社会经济地位相关的疾病经验分配； 收集新型的生物测量，以区分疼痛/疲劳综合征的根。并评估 在高危患者中鉴定早期肾脏疾病的新型策略。纽约大学狼疮队列是一个“活生生” 生物座位> 900名患者招收，四分之三至少每年紧随其后两次，潜水员 背景（50％的少数民族种族； 30％西班牙裔）和社会经济状况（31％的公立医院患者） 随着时间的推移提供样品。数据包括人口统计数据，随着时间的推移，已建立的分类标准， 药物，常规代谢和血液学参数，基于实验室的尿液分析，自身抗体 使用经过验证的仪器精确的轮廓，疾病活动波动和器官损伤，并报告了 成果和社会经济地位和地位的措施以及材料，行为，社会心理，健康 系统和健康结果。我们建议将纵向队列与电子健康联系起来 记录和全州范围内的全付款人索赔合并症数据，新的细胞因子概况和转录组的数据 模块，并实施一种鉴定早期肾脏疾病的新型策略。我们的多学科团队将 解决三个具体目的：1）量化狼疮患者的多种多发性和主要医疗保健使用 提高对狼疮和非狼疮合并症的理解，包括社会人口统计学的差异 因素； 2）测量狼疮对生活质量的燃烧，并分析以评估差距 社会人口统计学因素，行为和社会心理因素以及遗传信息； 3）发展和 评估具有肾炎风险升高的患者的创新性，以技术驱动的家庭蛋白尿测试。 总体而言，预计这项研究将为狼疮流行病学提供显着提高的了解， 包括与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的目标。