Accrual of organ damage over time in Argentine patients with systemic lupus erythematosus: a multi-centre study

Cassano, Gustavo; Roverano, Susana; Paira, Sergio; Bellomio, Verónica; Lucero, Eleonora; Berman, Alberto; Spindler, Alberto; Trobo, Rosana; Somma, Luis Fernando; Graf, César; Barrionuevo, Alejandra; Papasidero, Sílvia; Oscar, Rillo

doi:10.1007/s10067-007-0604-3

Cited by 30 publications

(14 citation statements)

References 17 publications

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“…Taking in account the characteristics of the studied population, these findings are concordant with the pattern of organ damage accrual described by Gladman et al 9 However, in cohorts from a different ethnic background, renal and neuropsychiatric disease seem to be major contributors to damage. 8,15,16 In this study we demonstrated that the progression of damage in Portuguese SLE patients is associated with disease-related and therapyrelated factors. Damage accrual was significantly greater in older patients and in those testing positive for aPL antibodies.…”

Section: Discussionmentioning

confidence: 59%

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Predictors of Damage Progression in Portuguese Patients with Systemic Lupus Erythematosus

Santos

Vinagre

Nero

et al. 2009

Annals of the New York Academy of Sciences

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Patients with systemic lupus erythematosus (SLE) have a longer life expectancy. The occurrence of irreversible damage has become a major concern. The present study assessed damage progression in patients with SLE over a 2-year period and identified baseline features associated with damage accrual. Two hundred and twenty-one patients that fulfilled criteria for SLE and had a follow-up longer than 6 months were enrolled. Demographic, clinical, and immunological data were collected at baseline. Accumulated organ damage was scored using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index (SDI). Patients were prospectively followed and SDI assessment repeated at 2 years. At baseline 72 patients (33%) presented some irreversible damage, and after 2 years 53 had accrued new damage. The mean SDI for the whole cohort increased from 0.582 to 0.980. Damage progression was higher in ocular, cardiovascular, and musculoskeletal systems. Older age [OR = 1.045; 95% confidence interval (CI) 1.021-1.069; P = 0.03], presence of antiphospholipid antibodies (OR = 3.047; 95% CI 1.169-7.941; P = 0.02), steroid use (OR = 6.401; 95% CI 1.601-25.210; P = 0.008), azathioprine use (OR = 3.501; CI 1.224-10.012; P = 0.01), and hypertension (OR = 3.825; 95% CI 1.490-9.820; P = 0.005) were predictors of damage progression in multivariate analysis. Overall SDI increased over time, with some systems being affected more frequently. Demographic and clinical characteristics, co-morbidity, and treatment options may contribute to irreversible damage. It is necessary to determine whether the control of modifiable factors (e.g., hypertension and judicious use of medications) might prevent damage progression in SLE patients.

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Section: Discussionmentioning

confidence: 59%

“…Taking in account the characteristics of the studied population, these findings are concordant with the pattern of organ damage accrual described by Gladman et al 9 . However, in cohorts from a different ethnic background, renal and neuropsychiatric disease seem to be major contributors to damage 8,15,16 …”

Section: Discussionmentioning

confidence: 99%

Predictors of Damage Progression in Portuguese Patients with Systemic Lupus Erythematosus

Santos

Vinagre

Nero

et al. 2009

Annals of the New York Academy of Sciences

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“…Cardiovascular damage in our cohort was less common (3.1%) although Asian SLE patients have been shown to develop less cardiovascular damage than those of other ethnicities . Most cardiovascular damage in our cohort consisted of pericarditis (1.6%) and angina (0.9%), while Chinese (10.7%) and Jewish (17.2%) people develop cardiovascular damage at a similarly high frequency as non‐Asians (10–16%) …”

Section: Discussionmentioning

confidence: 65%

Assessment of clinical manifestations, disease activity and organ damage in 996 Korean patients with systemic lupus erythematosus: comparison with other Asian populations

Joo

Bae

2014

Int J of Rheum Dis

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Compared to other Asian cohorts, disease activity was lower and organ damage was less in our Korean cohort. Nephritis, serositis and neuropsychiatric symptoms increased continuously over time. Overall disease activity decreased significantly, but a small portion of severe disease activity continued during the disease course. The most common organ damage was musculoskeletal. The time in organ damage development varied, which reflects the possible causality, such as disease itself and/or treatment.

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“…Finally, the rate of change of damage was estimated based on conversion to an annual rate of change. This could result in an over‐ or underestimation of the actual rate of damage accrual, since the rate of change might not be constant but could increase with longer disease duration, as in patients with SLE (36).…”

Section: Discussionmentioning

confidence: 99%

Damage extent and predictors in adult and juvenile dermatomyositis and polymyositis as determined with the myositis damage index

Rider¹,

Lachenbruch²,

Monroe³

et al. 2009

Arthritis & Rheumatism

112

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Objective. We undertook this study to validate the Myositis Damage Index (MDI) in juvenile and adult myositis, to describe the degree and types of damage and to develop predictors of damage.Methods. Retrospective MDI evaluations and prospective assessment of disease activity and illness features were conducted. Patients with juvenile-onset disease (n ‫؍‬ 143) were evaluated a median of 18 months after diagnosis; 135 patients were assessed 7-9 months later, and 121 were last assessed a median of 82 months after diagnosis. Ninety-six patients with adult-onset dermatomyositis or polymyositis had a baseline assessment a median of 30 months after diagnosis; 77 patients had a 6-month followup evaluation, and 55 had a final assessment a median of 60 months after diagnosis.Results. Damage was present in 79% of juvenile patients and in 97% of adult patients. In juveniles, scarring, contractures, persistent weakness, muscle dysfunction, and calcinosis were most frequent (23-30%) at the last evaluation. In adults, muscle atrophy, muscle dysfunction, and muscle weakness were most frequent (74-84%). MDI severity correlated with physicianassessed global damage, serum creatinine, and muscle atrophy on magnetic resonance imaging, and in juveniles also with functional disability and weakness. MDI damage scores and frequency were highest in patients with a chronic illness course and in adult patients who died. Predictors of damage included functional disability, duration of active disease, disease severity at diagnosis, physician-assessed global disease activity, and illness features, including ulcerations in children and pericarditis in adults.Conclusion. Damage is common in myositis after a median duration of 5 years in patients with adultonset disease and 6.8 years in patients with juvenileonset disease. The MDI has good content, construct, and predictive validity in juvenile and adult myositis.The idiopathic inflammatory myopathies (IIMs) constitute a common cause of acquired myopathy in adults and children. These systemic autoimmune diseases, although treatable with immunosuppressive medications, often result in a chronic illness course, func-

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Accrual of organ damage over time in Argentine patients with systemic lupus erythematosus: a multi-centre study

Cited by 30 publications

References 17 publications

Predictors of Damage Progression in Portuguese Patients with Systemic Lupus Erythematosus

Predictors of Damage Progression in Portuguese Patients with Systemic Lupus Erythematosus

Assessment of clinical manifestations, disease activity and organ damage in 996 Korean patients with systemic lupus erythematosus: comparison with other Asian populations

Damage extent and predictors in adult and juvenile dermatomyositis and polymyositis as determined with the myositis damage index

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