Comment on: Temporal relationships between systemic lupus erythematosus and comorbidities: reply

In this study, we used a looser definition proposed by Feinstein, specifically: ‘Any distinct additional entity that has existed or may occur during the clinical course of a patient who has the index disease under study’ [3]. The relationships between index disease and comorbidity are very complex [4] but can be broadly classified into three models: direct causation, associated risk factors and phenotypic variation [5]. Certainly, knowing the mechanism of the relationships may be useful. However, we intended not to delineate the relationship between the index disease (SLE) and comorbidities, as (i) the mechanisms of the relationship are not necessarily obvious or well-accepted; (ii) the categorization according to the mechanism is beyond the scope of the study; and (iii) the sheer existence of the comorbidity warrants clinical investigations. Irrespective of whether these comorbidities are directly or indirectly related to SLE or part of the phenotypic variations of SLE, they should be evaluated and managed in SLE patients.

Source: Rheumatology - July 10, 2019 Category: Rheumatology Source Type: research