ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 748

Comparison of Systemic Lupus Erythematosus in 3 Different Asian Ethnic Groups: Results from the 1000 Faces of Lupus Cohort

Mai Nguyen1, Earl Silverman2, Janet E. Pope3, Paul R. Fortin4, Ann E. Clarke5, Christian Pineau6, Sasha R Bernatsky7, C Douglas Smith8, Gaëlle Chédeville9, Lori B. Tucker10, Michel Zummer11, Marie Hudson6, Adam M. Huber12, Deborah M. Levy13, Hector Arbillaga14, Carol Hitchon15, Christine A. Peschken16 and CaNIOS 1000 Faces Investigators, 1Medicine, University of Manitoba, Winnipeg, MB, Canada, 2Division of Rheumatology, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada, 3University of Western Ontario, London, ON, Canada, 4Medicine, CHU de Québec - Université Laval, Québec, QC, Canada, 5Immunology/Epidemiology, Montreal General Hospital, Montreal, QC, Canada, 6Medicine, McGill University, Montreal, QC, Canada, 7Division of Rheumatolog, McGill Unversity Health Cener, Montreal, QC, Canada, 8The Arthritis Centre, TOH Riverside Campus, Ottawa, ON, Canada, 9Rheumatology, McGill University, Montreal, QC, Canada, 10Rheumatology, BC Children's Hospital, Vancouver, BC, Canada, 11Rheumatology, Hôpital Maisonneuve-Rosemont and University of Montreal, Montreal, QC, Canada, 12Pediatric rheumatology, IWK Health Centre, Halifax, NS, Canada, 13Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada, 14Calgary Rheumatology, Calgary, AB, Canada, 15University of Manitoba, Winnipeg, MB, Canada, 16Rheumatology, Univ of Manitoba, Winnipeg, MB, Canada

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: ,

Session Information

Date: Sunday, November 8, 2015

Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment Poster Session I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Ethnic variations in systemic lupus erythematosus (SLE) are well described, with more prevalent and severe disease in non-Caucasians including North American Asians. However, Asian ethnicity includes broad cultural, geographic and genetic diversity, and there is limited data examining SLE among Asian ethnicity subsets.  We describe SLE in 3 Asian subgroups from a large SLE cohort.

Methods: The 1000 Faces of Lupus is a multicentre Canadian cohort of over 2000 SLE patients.  Sociodemographics, ACR classification criteria (ACRc), autoantibodies, disease activity scores (SLEDAI), Systemic Lupus International Collaborating Clinics damage index (SDI) scores, and treatments are collected using standardized tools.  Ethnicity was self-reported and Asian subgroups were divided by geographic country of origin into East Asian (EA), Southeast Asian (SEA), South Asian (SA) and Central Asian (CA). Data at cohort entry for Asians and Caucasians were abstracted and cross-sectional univariate analyses including T tests, one-way ANOVA, and chi-square tests were performed.

Results: There were 334 Asians (176 EA, 78 SEA, and 78 SA, and 2 CA), and 1275 Caucasians.  CA were excluded. Onset age for Asians was similarly young (EA=23±13 years; SEA=21±10 years; SA=20±11 years) compared to Caucasians (33±15 years, p<0.001).  Childhood onset was frequent in Asians (EA=49%; SEA=51%; SA=61%) compared to Caucasians (17%, p<0.001). Over 40% of all Asians were immigrants. The proportion of males was higher in Asians (EA=15%; SEA=16%; SA=19%) compared to Caucasians (10%, p=0.008).  ACRc or SLEDAI scores were not different, while all Asians had a higher frequency of nephritis (EA=57%; SEA=63%; SA=51%), compared to Caucasians (33%, p<0.001). More Asians were dsDNA+ (ever) (EA=62%; SEA=63%; SA=78%) compared to Caucasians (52%, p<0.001). SEA were most frequently antiSm+ and antiRNP+ (ever) (EA=31%; SEA=50%; SA=30%; p=0.01, and EA=20%; SEA=32%; SA=22%; p=0.03), but all Asians were higher than Caucasians (19%, p<0.001; 16%, p<0.001).  More SA were antiphospholipid antibody positive (ever) (EA=26%; SEA=18%; SA=37%, p=0.04) but overall not different from Caucasians (24%). Over 90% of Asians graduated high school compared to Caucasians (83%, p=0.007).  Most Asians were in the highest income tier (EA=55%; SEA=42%; SA=58%), similar to Caucasians (51%). Treatment with prednisone (EA=55%; SEA=67%; SA=65%), cyclophosphamide (EA=13%; SEA=21%; SA=20%), and mycophenolate (EA=15%; SEA=19%; SA=9%) was relatively frequent in Asians, likely reflecting the high frequency of nephritis.  The mean disease duration in Asians was 8 years but most had not accumulated damage (SDI=0 in 66% EA; 64% SEA; 79% SA) compared to Caucasians (47%, p<0.001).

Conclusion: This is the first study to compare SLE in North American Asian subgroups. Childhood onset SLE is more common in Asians than Caucasians. Disease appears severe but not different between the Asian groups. People of Asian subcontinental ethnic origin are the fastest growing ethnic group in North America. Young onset age and a high proportion of 1st generation immigrants suggest the potential for a growing burden of SLE in this population. Future studies of outcomes and optimal treatments are indicated.

Disclosure: M. Nguyen, None; E. Silverman, None; J. E. Pope, Amgen, 2; P. R. Fortin, GlaxoSmithKline, 5,Lilly, 5,AbbVie, 5; A. E. Clarke, None; C. Pineau, None; S. R Bernatsky, None; C. D. Smith, None; G. Chédeville, None; L. B. Tucker, None; M. Zummer, Janssen Inc, 5; M. Hudson, None; A. M. Huber, None; D. M. Levy, None; H. Arbillaga, None; C. Hitchon, None; C. A. Peschken, None.

To cite this abstract in AMA style:

Nguyen M, Silverman E, Pope JE, Fortin PR, Clarke AE, Pineau C, R Bernatsky S, Smith CD, Chédeville G, Tucker LB, Zummer M, Hudson M, Huber AM, Levy DM, Arbillaga H, Hitchon C, Peschken CA. Comparison of Systemic Lupus Erythematosus in 3 Different Asian Ethnic Groups: Results from the 1000 Faces of Lupus Cohort [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/comparison-of-systemic-lupus-erythematosus-in-3-different-asian-ethnic-groups-results-from-the-1000-faces-of-lupus-cohort/. Accessed .

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