Characterization of damage in Portuguese lupus patients: analysis of a national lupus registry.

Abstract:

BACKGROUND:Although the survival rate has considerably improved, many patients with systemic lupus erythematosus (SLE) develop irreversible organ damage. OBJECTIVES:The objectives of this paper are to characterize cumulative damage in SLE patients and identify variables associated with its presence and severity. METHODS:A cross-sectional analysis of SLE patients from the Portuguese Lupus register Reuma.pt/SLE in whom damage assessment using the SLICC/ACR-Disability Index (SDI) was available was performed. Predictor factors for damage, defined as SDI ≥ 1, were determined by logistic regression analyses. A sub-analysis of patients with severe damage (SDI ≥ 3) was also performed. RESULTS:In total, 976 patients were included. SDI was ≥1 in 365 patients, of whom 89 had severe damage. Musculoskeletal (24.4%), neuropsychiatric (24.1%) and ocular (17.2%) domains were the most commonly affected. Older age, longer disease duration, renal involvement, presence of antiphospholipid antibodies and current therapy with steroids were independently associated with SDI ≥ 1. The subpopulation with severe damage had, in addition, a greater interval between the first manifestation attributable to SLE and the clinical diagnosis as well as and more frequently early retirement due to SLE. CONCLUSIONS:This large lupus cohort confirmed that demographic and clinical characteristics as well as medication are independently associated with damage. Additionally, premature retirement occurs more often in patients with SDI ≥ 3. Diagnosis delay might contribute to damage accrual.

journal_name

Lupus

journal_title

Lupus

authors

Gonçalves MJ,Sousa S,Inês LS,Duarte C,Borges J,Silva C,Romão VC,Terroso G,Bernardes M,Cerqueira M,Raposo A,Sequeira G,Barcelos A,Macieira C,Canas da Silva J,Costa L,Pereira da Silva JA,Cunha-Miranda L,Da Silva JA,Ca

doi

10.1177/0961203314555172

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

256-62

issue

3

eissn

0961-2033

issn

1477-0962

pii

0961203314555172

journal_volume

24

pub_type

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