M J Gonçalves1, S Sousa2, L S Inês3, C Duarte3, J Borges4, C Silva4, V C Romão5, G Terroso6, M Bernardes6, M Cerqueira7, A Raposo7, G Sequeira8, A Barcelos9, C Macieira10, J Canas da Silva11, L Costa6, J A Pereira da Silva10, L Cunha-Miranda4, J A P Da Silva3, H Canhão1, M J Santos12. 1. Hospital de Santa Maria, Lisboa, Portugal Rheumatology Research Unit, Instituto de Medicina Molecular, Lisboa, Portugal. 2. Hospital Garcia de Orta, Almada, Portugal sandrainsousa@gmail.com. 3. Hospitais da Universidade de Coimbra, Coimbra, Portugal. 4. Instituto Português de Reumatologia, Lisboa, Portugal. 5. Hospital de Santa Maria, Lisboa, Portugal Hospital Garcia de Orta, Almada, Portugal. 6. Hospital de São João, Porto, Portugal. 7. Hospital Conde de Bertiandos, Ponte de Lima, Portugal. 8. Hospital de Faro, Faro, Portugal. 9. Hospital de Aveiro, Aveiro, Portugal. 10. Hospital de Santa Maria, Lisboa, Portugal. 11. Rheumatology Research Unit, Instituto de Medicina Molecular, Lisboa, Portugal. 12. Rheumatology Research Unit, Instituto de Medicina Molecular, Lisboa, Portugal Hospital Garcia de Orta, Almada, Portugal.
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.
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 SLEpatients and identify variables associated with its presence and severity. METHODS: A cross-sectional analysis of SLEpatients 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.
Authors: S Sousa; M J Gonçalves; L S Inês; G Eugénio; D Jesus; S Fernandes; G Terroso; V C Romão; M Cerqueira; A Raposo; M Couto; P Nero; G Sequeira; T Nóvoa; J A Melo Gomes; J Canas da Silva; L Costa; C Macieira; C Silva; J A P Silva; H Canhão; M J Santos Journal: Rheumatol Int Date: 2016-03-15 Impact factor: 2.631
Authors: M Frodlund; A Vikerfors; G Grosso; T Skogh; J Wetterö; K Elvin; I Gunnarsson; A Kastbom; Ö Dahlström; J Rönnelid; E Svenungsson; C Sjöwall Journal: Clin Exp Immunol Date: 2018-09-12 Impact factor: 4.330
Authors: Beatriz Tejera Segura; Brett Sydney Bernstein; Thomas McDonnell; Chris Wincup; Vera M Ripoll; Ian Giles; David Isenberg; Anisur Rahman Journal: Rheumatology (Oxford) Date: 2020-03-01 Impact factor: 7.580