Session Information
Date: Tuesday, November 10, 2015
Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment Poster Session III
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: To compare clinical features, disease activity and outcome in late onset versus early onset SLE over 5 years of follow up.
Methods: Patients with SLE are followed prospectively according to standard protocol and tracked on a computerized database. Patients entering the cohort within one year of diagnosis constitute the inception cohort. Patients with late onset (age at diagnosis ≥ 50 were identified and matched 1:2 based on gender and first clinic visit (+/- 5) years with patients with early disease onset (age at diagnosis 18- 40 years). Groups were compared at baseline and 5-year follow up. Disease activity was measured by the SLE Disease Activity Index (SLEDAI-2K) and Damage was assessed by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology(SLICC/ACR) damage index. All information is collected prospectively in the database.
Results: A total of 86 patients with late onset disease (84.9% female,81.4% Caucasian ,mean age ±SD 58.05 ± 7.30 ) and 169 patients with early onset disease (86.4% were female , 71% Caucasian, mean age± SD 27.80 ± 5.90 ) were identified.
|
Variables |
At baseline |
5 years |
||||
|
Late (N= 86) |
Early (N=169) |
P value |
Late (N= 86) |
Early (N=169) |
P value |
|
|
ACR criteria* |
4.92 ± 1.05 |
5.32 ± 1.15 |
0.001 |
5.60 ± 1.17 |
6.31 ± 1.34 |
0.0001 |
|
SLEDAI-2K score* |
4.58 ± 4.68 |
6.18 ± 6.24 |
0.006 |
3.41 ± 4.84 |
4.09 ± 4.40 |
0.173 |
|
Total SDI* |
0.15 ± 0.43 |
0.17 ± 0.60 |
0.928 |
0.98 ± 1.28 |
0.69 ± 1.16 |
0.005 |
|
SLICC ≥ 1 |
9(10.4%) |
17(10.1%) |
– |
43(50.1%) |
88(36.1%) |
– |
|
IS use |
11 (12.8%) |
43 (25.4%) |
0.001 |
19 (22.1%) |
61 (36.1%) |
0.001 |
|
Steroid use |
60 (69.8%) |
102 (60.4%) |
0.083 |
44 (51.2%) |
95 (56.2%) |
0.340 |
|
Average steroids dose in mg/d |
22.53 ± 13.07 |
30.23 ±19.35 |
0.021 |
12.58 ± 6.60 |
15.18±8.51 |
0.004 |
|
* Mean ± SD ; IS= immunosuppressive |
||||||
At enrollment, late onset SLE had a lower total number of ACR criteria, less renal and neurologic manifestations. Mean SLEDAI-2K scores were lower in late onset SLE, especially renal features and anti-DNA positivity. Over 5 years, mean SLEDAI-2K scores decreased in both groups, while mean SDI scores increased more significantly in the late onset group ; they developed more cardiovascular, renal and ocular damage , had higher prevalence of hypertension and hypercholesterolemia.
Conclusion: Although late onset SLE group had a milder presentation and less active disease, with the evolution of disease, they developed more organ damage likely a consequence of cardiovascular risk factors and aging.
To cite this abstract in AMA style:
Al Johani R, Gladman D, Su J, Urowitz M. Disease Evolution in Late Onset and Early Onset Systemic Lupus Erythematosus (SLE) [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/disease-evolution-in-late-onset-and-early-onset-systemic-lupus-erythematosus-sle/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/disease-evolution-in-late-onset-and-early-onset-systemic-lupus-erythematosus-sle/