Systemic lupus erythematosus: Follow-up study of 148 patients. I: Classification, clinical and laboratory findings, course and outcome

Abstract

The present paper is a description of 148 patients with circulating antinuclear antibodies and multisystemic disease filed during 18 years by one of the authors and followed up to date in 1981-83. Seventy-eight per cent of the patients satisfied the 1971 ARA criteria for the classification of systemic lupus erythematosus and 92 per cent fulfilled the 1982 ARA criteria. Eighty-five per cent were women, the mean age at onset of SLE was 32 years. Malar rash and arthritis were early manifestations in 80 per cent of the patients whereas the onset of nephropathy, CNS manifestations, serositis, and peripheral cytopenia was delayed in about half of the patients. Nephropathy and thrombocytopenia were observed particularly in the youngest patients. The mean duration of the observation period was 8 years. The 10-year-survival was 80 per cent. Half of the deaths were presumably unrelated to SLE. The mean ages at entry of patients who died of SLE and of unrelated causes were 30 and 52 years respectively. Eighteen per cent of the deaths were caused by uremia and 18 per cent by infections. The total and the SLE related mortalities were evenly distributed throughout the observation period. The morbidity (incidence of new ARA criteria and other findings indicating active disease) decreased during the first year of observation but rarely subsided completely during the following years. All patients observed for more than 10 years showed evidence of active disease during the rest of the observation period and most showed evidence of renal disease.

Long‐term survival in systemic lupus erythematosus patient characteristics associated with poorer outcomes

“…Survival rates in this cohort were generally lower than those reported in other studies of survival in patients with SLE. Among studies published since 1980, the 5-year and 10-year survival estimates averaged 87% and 86%, respectively (7)(8)(9)(10)(11)(12)1422). In the 3 previous studies that reported 15-year survival estimates, these estimates averaged 79% (7,16,19).…”

Is there a cure for systemic lupus erythematosus?

“…In recent decades the treatment and life expectancy of SLE patients have been significantly improved. 2,4,17,18 Despite that, evidence suggests that the quality of this extended life can remain poor compared with that of the general population and worse than that of individuals with other chronic diseases. 19,20 In the majority of patients the disease is no longer an acute life-threatening disease but a chronic one.…”

A multicentre study of 513 Danish patients with systemic lupus erythematosus. I. Disease manifestations and analyses of clinical subsets

“…The natural history of the disease is characterised by episodes of relapses, 'flares', interchanging with remissions, and the outcome is highly variable ranging from permanent remission to death. Important co-morbidity is caused by infections and thromboembolic episodes [2,3]. The age of the patients at onset may significantly influence the course of the disease [4,5].…”