Rheumatology Advance Access published online on August 15, 2003
Rheumatology, doi:10.1093/rheumatology/keg481
Rheumatology © British Society for Rheumatology 2003; all rights reserved
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Original Papers
1 Department of Medicine (Division of Clinical Immunology and Rheumatology), Schools of Medicine and Public Healh, University of Alabama at Birmingham, Birmingham, AL, USA
* Corresponding author. E-mail: graciela.alarcon{at}ccc.uab.edu.
Received 11 February 2003
; accepted 3 July 2003
Objective. To examine the predictors of damage in a multiethnic cohort of systemic lupus erythematosus (SLE) patients with a specific focus on damage at baseline. Patients and methods. SLE patients from a multiethnic US (Hispanic, African-American and Caucasian) cohort (LUMINA: Lupus in Minority populations, Nature versus nurture) were included if they had Results. Three hundred and fifty-two patients (82 Hispanics, 153 African-Americans and 117 Caucasians) representing 1795 patient visits were included. Previous damage was found to be a significant predictor of subsequent damage accrual (P < 0.0001). Other variables predictive of subsequent damage accrual were disease activity (P < 0.0001), older age (P = 0.041) and use of corticosteroids (P = 0.0048). Conclusions. Once damage occurs in SLE, further damage is expected to occur. This is more likely to be the case if disease activity persists. These data have clinical implications for the management of SLE patients.
Key words: Lupus, Damage, Ethnicity, Outcome, Predictors.
Systemic lupus erythematosus in three ethnic groups. XX. Damage as a predictor of further damage
2 Department of Epidemiology, Schools of Medicine and Public Healh, University of Alabama at Birmingham, Birmingham, AL, USA
3 Department of Epidemiology, Schools of Medicine and Public Healh, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Surgery (Section of Trauma, Burns, and Critical Care), Schools of Medicine and Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
4 Department of Medicine (Division of Rheumatology), University of Texas Medical Branch at Galveston, Galveston, TX, USA
5 Department of Medicine (Division of Rheumatology and Clinical Immunogenetics), University of Texas-Houston Health Science Center, Houston, TX, USA
6 months of follow-up in the cohort. Damage was measured with the Systemic Lupus International Collaborating Clinics (SLICC) Damage Index (SDI). The dependent variable was the change in SDI score between study visits. Predictors were from the preceding visit. Variables known to affect damage accrual in SLE were included in the analyses.
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