Background/Purpose: Systemic lupus erythematosus (SLE) is a complex autoimmune disease defined by its heterogeneity and cycles of flares and remissions. Owing to non-specific or incomplete sequelae, diagnosing lupus represents a considerable clinical challenge. Despite increased awareness among physicians and patients, considerable diagnostic delays in SLE persist. The objective of this study was to identify factors contributing to delays in SLE diagnosis.

Methods: We performed cross-sectional analysis of 925 US patients with SLE registered in the Lupus Foundation of America Research Accelerated by You (RAY®) registry from October 2020 to May 2023. The Accelerated Failure Time model was used to ascertain factors influencing time to diagnosis. Demographics variables including age, sex, race as well as onset of first symptoms and time of diagnosis were evaluated. The potential effect of income, educational attainment and US region were also determined.

Results: All participants included in the analysis were ultimately diagnosed with lupus. The average duration from symptom onset and diagnosis is 6.29±0.277 SE years. Using a multivariable log-logistic AFT model, we observed that age (β=.019, p< .001), residence in the southern region (β=0.227, p=.024) and identification as American Indian/Alaska Native (β=0.651,p=.008) were associated with prolonged time to SLE diagnosis. Conversely, Asian (β=-0.545, p=.006) and Black/African American race (β=-.366, p=.002) showed association with a shorter time to diagnosis. Evaluation of income indicated a potential association with a shorter time to diagnosis (β=-0.049, p=0.063); however, it was not statistically significant.

Conclusion: Diagnostic delays remain a considerable issue for individuals eventually diagnosed with lupus. Factors such as race, regional location, and age may contribute to time to diagnosis. Additional research is needed to explore the relationship between these variables and the timing of SLE diagnosis.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/factors-influencing-time-to-diagnosis-in-u-s-patients-with-systemic-lupus-erythematosus/