Lupus organ damage: what is damaged in Asian patients?

Wp, Kuan; Ek, Li; Tam, Lai‐Shan

doi:10.1177/0961203310370050

Cited by 23 publications

(23 citation statements)

References 39 publications

(94 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many studies have reported a younger age at onset of disease in Asian patients, which may allow for greater accumulation of disease‐related damage by a given age. Although overall damage accrual appears otherwise comparable between studies of Asian and Caucasian populations, renal damage is reported to appear excessively in Asians . Additionally, in studies from countries with universal access to healthcare, overall damage and mortality appears to be comparable between Asians and Caucasians, although specific domains of damage, such as renal damage, may be overrepresented in Asian patients in some studies .…”

Section: Damage and Mortalitymentioning

confidence: 86%

“…Although overall damage accrual appears otherwise comparable between studies of Asian and Caucasian populations, renal damage is reported to appear excessively in Asians. 29 Additionally, in studies from countries with universal access to healthcare, overall damage and mortality appears to be comparable between Asians and Caucasians, although specific domains of damage, such as renal damage, may be overrepresented in Asian patients in some studies. 27,30 In contrast, the most recent 5-year survival rates for SLE in developed Asian countries such as Hong Kong 31 were highly comparable with results from Western centres.…”

Section: Damage and Mortalitymentioning

confidence: 99%

See 1 more Smart Citation

Asian ethnicity in systemic lupus erythematosus: an Australian perspective

Connelly

Morand

Hoi

2013

Internal Medicine Journal

View full text Add to dashboard Cite

Ethnic differences in both disease susceptibility and expression have been noted in systemic lupus erythematosus (SLE). This review focuses on the evidence of disparities between SLE patients of Asian and Caucasian descent, the two predominant ethnic groups affected by SLE in the Australian context. While epidemiological studies suggest higher rates of SLE among Asian patients, multi-ethnic cohort studies have allowed direct comparison of disease characteristics between different ethnic groups. Such studies suggest that Asians are affected by more severe SLE across several disease parameters, including increased renal involvement, autoantibody positivity, disease activity and damage accumulation. As delineation of these disparities becomes clearer, uncovering the biological basis of such differences poses a significant opportunity to progress understanding of SLE pathogenesis. Understanding ethnic variation in disease provides a platform for an individualised approach to risk assessment, monitoring and management of SLE.

show abstract

Section: Damage and Mortalitymentioning

confidence: 86%

Section: Damage and Mortalitymentioning

confidence: 99%

Asian ethnicity in systemic lupus erythematosus: an Australian perspective

Connelly

Morand

Hoi

2013

Internal Medicine Journal

View full text Add to dashboard Cite

show abstract

“…Despite these differences, more recent evidence has suggested that Asian patients in the modern era may not necessarily have worse outcomes as traditionally thought. Regardless of varying disease manifestations and severity, the overall rate of damage accrual (as a consequence of disease or due to treatment) in Asian lupus does not seem to be notably different in comparison to Caucasian patients . Moreover, a recent large Medicaid study from the United States even reported lower mortality rates among Asian patients in comparison to their African American, Caucasian and Native American counterparts .…”

Section: Introductionmentioning

confidence: 96%

“…Regardless of varying disease manifestations and severity, the overall rate of damage accrual (as a consequence of disease or due to treatment) in Asian lupus does not seem to be notably different in comparison to Caucasian patients. 9 Moreover, a recent large Medicaid study from the United States even reported lower mortality rates among Asian patients in comparison to their African American, Caucasian and Native American counterparts. 10 A systemic review of SLE patients in China between 1995 and 2013 demonstrated 5-year and 10-year survival rates of 94% and 89%, respectively, which is at least comparable to Western counterparts.…”

Section: Introductionmentioning

confidence: 99%

Lupus in the far east: a modern epidemic

Lau

2017

Int J of Rheum Dis

View full text Add to dashboard Cite

Systemic lupus erythematosus (SLE) is a diverse and heterogeneous disease with much variation between different ethnicities. Although more severe and prevalent in non-Caucasian populations, the bulk of evidence regarding 'Asian lupus' had traditionally been extrapolated from studies on patient minorities in the West. Lupus research in Asia has since grown exponentially and now takes a leading role in improving the care for SLE patients worldwide. With recent advances, particularly from studies in population-specific phenotyping, genome-wide association studies, lupus nephritis and innovative treatment modalities, we now have an expanding understanding of both the basic science and clinical management of SLE. Upcoming breakthroughs from growing multi-ethnic cohorts and international collaborations will likely bring further important ramifications for SLE management in the near future.

show abstract

“…Interestingly, studies looking at the prevalence of renal damage in patients with SLE among Asians residing in western countries demonstrated a higher prevalence of damage compared to white patients, which was not confirmed in studies performed in China or Korea, but the increased renal damage in Asian patients was almost uniformly reported [49]. Asian patients may also have a higher rate of LN-associated antibodies, LN and more active glomerulonephritis compared to white patients [50].…”

Section: Ethnicity and Outcome Of Sle And Lnmentioning

confidence: 99%

Lupus Nephritis: A Different Disease in European Patients?

Tesař

Hrušková²

2015

Kidney Dis

View full text Add to dashboard Cite

Background: Lupus nephritis (LN) is still associated with significant mortality and substantial risk of progression to end-stage renal failure. Its outcome is related to the class and severity of LN and response to treatment, and it is poorer in patients with renal relapses. Ethnicity has a relatively well-defined impact on the outcome of the patients and their response to treatment and must always be taken into consideration in treatment decisions. Summary: In this article, we provide a review of the impact of ethnicity on the prevalence of systemic lupus erythematosus (SLE), the proportion of patients with SLE developing LN, outcomes of SLE and LN and response of LN to treatment. In European patients, the prevalence of SLE and the proportion of SLE patients with LN are lower and the outcome of LN is better than in nonwhite populations. European patients may respond better to some modes of treatment [e.g. cyclophosphamide (CYC) or rituximab] and may be less frequently refractory to treatment compared to black patients with LN. Although these differences may be largely genetically driven, socioeconomic factors (poverty, education, insurance, access to health care and adherence to treatment) may also play a significant role in some disadvantaged patients. Key Message: Treatment of LN may be different in patients with different ethnicity. Less aggressive disease in European patients may better respond to less aggressive treatment. Treatment of LN in nonwhite patients may require newer (more effective) therapeutic approaches, but targeting negative socioeconomic factors might be even more effective. Facts from East and West: (1) The prevalence of SLE is lower among Caucasians than other ethnicities. A higher prevalence is observed among Asians and African Americans, while the highest prevalence is found in Caribbean people. The prevalence of LN in Asian SLE patients is much higher than in Caucasians as well. However, the 10-year renal outcome and renal survival rate appear to be better in Asians. (2) Polymorphisms of genes involved in the immune response, such as Fcγ receptor, integrin alpha M, TNF superfamily 4, myotubularin-related protein 3 and many others, might be partly responsible for the differences in prevalence between the different ethnic groups. European ancestry was shown to be associated with a decrease in the risk of LN even after adjustment for genes most associated with renal disease. (3) Access to health care is a key determinant of disease progression, treatment outcome and the management of complications such as infections, particularly in South Asia, and might also explain disparities between clinical outcomes. (4) The efficacy of low-dose CYC combined with corticosteroids for induction treatment of LN was proved in European Caucasian patients. This treatment is also used in Asia, although no formal evaluation of efficacy and safety in comparison with other treatment regimens exists in this population. The efficacy of mycophenolate mofetil (MMF) is similar to that of CYC, and similar between Asi...

show abstract

Lupus organ damage: what is damaged in Asian patients?

Cited by 23 publications

References 39 publications

Asian ethnicity in systemic lupus erythematosus: an Australian perspective

Asian ethnicity in systemic lupus erythematosus: an Australian perspective

Lupus in the far east: a modern epidemic

Lupus Nephritis: A Different Disease in European Patients?

Contact Info

Product

Resources

About