ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2619

Low Socioeconomic Status (SES) As Measured By Education Is (not) Associated with Worse Outcome in SLE: Data from the 1000 Canadian Faces of Lupus

Angela George1, Christine Peschken2, Earl Silverman3, Christian A. Pineau4, C Douglas Smith5, Hector Arbillaga6, Michel Zummer7, Ann Clarke8, Sasha Bernatsky9, Marie Hudson10, Carol A. Hitchon11, Paul R. Fortin12 and Janet E. Pope13, 1Medicine/Rheumatology, University of Western Ontario, London, ON, Canada, 2Medicine & Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada, 3Pediatrics/Rheumatology, Toronto Hospital for Sick Children, U of Toronto, Toronto, ON, Canada, 4Rheumatology, McGill University Health Center, Montreal, QC, Canada, 5The Arthritis Centre, TOH Riverside Campus, Ottawa, ON, Canada, 6Medicine/Rheumatology, Lethbridge Rheumatology practice, Lethbridge, AB, Canada, 7Medicine/Rheumatology, U of Montreal, Montreal, QC, Canada, 8Medicine/Allergy, U of Calgary, Calgary, AB, Canada, 9Clinical Epidemiology, McGill UHC/RVH, Montreal, QC, Canada, 10Medicine/Rheumatology, McGill University, Montreal, QC, Canada, 11Rheumatology, University of Manitoba, Winnipeg, MB, Canada, 12Rheumatology, Laval University, Division of Rheumatology, Centre de Recherche du CHU de Québec and Department of Medicine, Quebec City, QC, Canada, 13St Joseph Health Care, London, ON, Canada

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: , ,

Session Information

Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment: Epidemiology, Women's Health, Cardiovascular and CNS

Session Type: Abstract Submissions (ACR)

Background/Purpose:

To determine whether socioeconomic status, as measured by education, impacts disease activity (measured by SLAM-2, SLEDAI-2K) or disease damage (measured by SLICC SDI) in patients with systemic lupus erythematosus (SLE). 

Methods:

Data from the 1000 Canadian Faces of Lupus, a multi-center, prospective cohort database included adult SLE patients from June 2005 onward. Socioeconomic status, as measured by education was defined as being either low (did not complete high school) or high (completed high school or further). The relationships between education and SLE outcomes were evaluated using one-way ANOVA and logistic regression analyses.  

Results: 484 patients met inclusion criteria (mean age 47 years, 91.5% female, mean disease duration of 10 years); 80.4% had completed high school education or higher and 19.6% had not. One-way ANOVA analyses demonstrated: SLEDAI-2K (p=0.01), SLAM-2 (p<0.3) and SLICC (p=1.0). Proportionately more Aboriginal people were in the low education group (6.4% in high education vs. 17.9% in low education) and work disability was twice as common in low education group (13.6% vs. 28.4%). Income was higher in high education stratum. Logistic regression did not demonstrate significance between education and SLEDAI-2K when adjusting for age, sex, ethnicity, and disease duration. See table for results.

*P<0.05

High SES

Low SES

Total (% of group)

389 (80.4)

95 (19.6)

     Female

360 (92.5)

83 (87.4)

Age, mean (SD), years

44.9 (12.8)

54.9 (13.2)

Ethnicity†

     Caucasian

     Black

     Asian

     Aboriginal

287 (73.8)

38 (9.8)

39 (10)

25 (6.4)

72 (75.8)

4 (4.2)

2 (2.1)

17 (17.9)*

Work Disabled ¤

53 (13.6)

27 (28.4)*

Disease Duration

10.4 (8.9)

10.8 (9.6)

Income Level††

Per annum household income

     <$15,000

     $15,000 – $29,999

     $30,000-$49,999

     ≥$50,000

30 (7.7)

47 (12.1)

68 (17.5)

136 (35)

19 (20)

8 (8.4)

16 (16.8)

8 (8.4)*

Disease Activity

    SLAM-2

    SLEDAI-2K

6.01 (3.8)

4.40 (4.1)

5.67(4.1)

5.67(5.2)

Disease Damage

    SLICC

1.34 (1.8)

1.33 (1.8)

Conclusion: This was mostly a prevalent, cohort so low income and work disability could be a result of SLE disease activity and damage. This cohort was literate and had access to lupus specialists so data may not be generalizable. Socioeconomic status, as measured by education, did not impact damage or disease activity in this cohort.

Disclosure:

A. George,
None;

C. Peschken,
None;

E. Silverman,
None;

C. A. Pineau,
None;

C. D. Smith,
None;

H. Arbillaga,
None;

M. Zummer,
None;

A. Clarke,
None;

S. Bernatsky,
None;

M. Hudson,
None;

C. A. Hitchon,
None;

P. R. Fortin,
None;

J. E. Pope,
None.

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