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Characterization of damage in Portuguese lupus patients: analysis of a national lupus registry

2014; SAGE Publishing; Volume: 24; Issue: 3 Linguagem: Inglês

10.1177/0961203314555172

1477-0962

Anabela Susana de Sousa Gonçalves, Sandra Sousa, Luís Inês, Cátia Duarte, J. Borges, C Silva, Vasco C. Romão, G. Terroso, Miguel Bernardes, Marcos Cerqueira, A. Raposo, Graça Sequeira, Anabela Barcelos, C. Macieira, J Canas da Silva, L. Costa, J A Pereira da Silva, L. Cunha-Miranda, José António Pereira da Silva, Helena Canhão, María José Santos,

Cytokine Signaling Pathways and Interactions

Background: Although the survival rate has considerably improved, many patients with systemic lupus erythematosus (SLE) develop irreversible organ damage. Objectives: The objectives of this paper are to characterize cumulative damage in SLE patients and identify variables associated with its presence and severity. Methods: A cross-sectional analysis of SLE patients from the Portuguese Lupus register Reuma.pt/SLE in whom damage assessment using the SLICC/ACR-Disability Index (SDI) was available was performed. Predictor factors for damage, defined as SDI ≥ 1, were determined by logistic regression analyses. A sub-analysis of patients with severe damage (SDI ≥ 3) was also performed. Results: In total, 976 patients were included. SDI was ≥1 in 365 patients, of whom 89 had severe damage. Musculoskeletal (24.4%), neuropsychiatric (24.1%) and ocular (17.2%) domains were the most commonly affected. Older age, longer disease duration, renal involvement, presence of antiphospholipid antibodies and current therapy with steroids were independently associated with SDI ≥ 1. The subpopulation with severe damage had, in addition, a greater interval between the first manifestation attributable to SLE and the clinical diagnosis as well as and more frequently early retirement due to SLE. Conclusions: This large lupus cohort confirmed that demographic and clinical characteristics as well as medication are independently associated with damage. Additionally, premature retirement occurs more often in patients with SDI ≥ 3. Diagnosis delay might contribute to damage accrual.