Systemic lupus erythematosus in a multiethnic US cohort. XXXIII. Clinical [corrected] features, course, and outcome in patients with late-onset disease.

Full Abstract

OBJECTIVE:
To examine the clinical differences and the type and extent of organ damage in late- versus early-onset systemic lupus erythematosus (SLE).

METHODS:
A nested case-control study was performed in the context of LUMINA (LUpus in MInorities, NAture versus nurture), a large, longitudinal, multiethnic cohort. Patients who developed SLE at or after the age of 50 years were considered cases. Two controls (patients who developed SLE at age < or = 49 years) per case, matched for sex and disease duration, were randomly chosen. Selected baseline socioeconomic/demographic, behavioral, and psychological features, self-reported quality of life, and cumulative clinical data (clinical manifestations, laboratory data, disease activity, damage, and mortality) were compared between cases and controls. Multivariable analyses with late-onset lupus, damage accrual, and mortality as dependent variables were then performed.

RESULTS:
Two hundred seventeen patients were studied. Of them, 73 were cases. Cases were more likely to have neurologic involvement, arterial thrombotic events, osteoporosis, and hypertriglyceridemia, while renal involvement and anti-Sm antibodies were less frequent. Disease activity at baseline was lower among cases. Cases also exhibited more cardiovascular and ocular damage. Late-onset lupus was an independent predictor of damage accrual (t-test = 2.23, P = 0.028), any damage at last visit (odds ratio [OR] 23.32, 95% confidence interval [95% CI] 3.98-141.56) (P < 0.001), and mortality (OR 10.74, 95% CI 3.07-37.56) (P < 0.001).

CONCLUSION:
Patients with late-onset lupus exhibit distinct clinical features. Although disease activity tends to be lower in these patients, they tend to accrue more damage and experience higher mortality than patients with early-onset lupus. These findings probably reflect the contribution exerted by other comorbid conditions in the overall impact of lupus in these patients.

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Author information

Author/s: Bertoli, Ana M (AM); Alarcón, Graciela S (GS); Calvo-Alén, Jaime (J); Fernández, Mónica (M); Vilá, Luis M (LM); Reveille, John D (JD); LUMINA Study Group;

Affiliation: University of Alabama at Birmingham School of Medicine, USA.

Grants: 1P20-RR-11126 (Agency:NCRR NIH HHS) ; M01-RR-00032 (Agency:NCRR NIH HHS) ; M01-RR-02558 (Agency:NCRR NIH HHS) ; R01-AR-42503 (Agency:NIAMS NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: Arthritis and rheumatism (Arthritis Rheum), published in United States. (Language: eng)

Reference: 2006-May; vol 54 (issue 5) : pp 1580-7

Dates: Created 2006/05/09; Completed 2006/08/04; Revised 2007/11/14;

PMID: 16645994, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

ErratumIn: Arthritis Rheum. 2006 Jul;54(7):2320.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Humans
Lupus Erythematosus, Systemic - diagnosis; ethnology; therapy
Male
Middle Aged
Multivariate Analysis
United States

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