Systemic Lupus Erythematosus in Men: A Retrospective Analysis in a Veterans Administration Healthcare System Population

Prete, Pamela E.; Majlessi, Azadeh; Gilman, Stuart C.; Hamideh, Fayad

doi:10.1097/00124743-200106000-00003

Cited by 26 publications

(26 citation statements)

References 42 publications

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“…Numerous studies demonstrate that men with SLE are more likely to have organ damage, including renal disease and neuropsychiatric abnormalities, and have an increased mortality rate 1 year following initial SLE hospitalization . A previous analysis has shown that men develop lupus nephritis earlier than women, with a reported relative hazard of 1.7 .…”

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Differences in the Prevalence and Time to Onset of Manifestations of Systemic Lupus Erythematosus: The California Lupus Surveillance Project

Maningding

Dall’Era

Trupin

et al. 2020

Arthritis Care & Research

100

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Objective. The California Lupus Surveillance Project (CLSP) is a population-based registry of individuals with systemic lupus erythematosus (SLE) residing in San Francisco County, California from 2007 to 2009, with a special focus on Asian/Pacific Islander and Hispanic patients. We used retrospective CLSP data to analyze racial and ethnic differences in lupus manifestations and in the timing and risk of developing severe manifestations.Methods. A total of 724 patients with SLE were retrospectively identified. Prevalence ratios (PRs) of SLE manifestations were calculated using Poisson regression models stratified by race/ethnicity and adjusted for sex, age at SLE diagnosis, and disease duration. We studied onset of severe SLE manifestations after SLE diagnosis using Kaplan-Meier methods to examine time-to-event and Cox proportional hazards regression models to estimate hazard ratios (HRs). White patients were the referent group in all analyses.Results. African Americans, Asian/Pacific Islanders, and Hispanic patients had increased prevalence of renal manifestations (PR 1.74 [95% confidence interval (95% CI) 1.40-2.16], PR 1.68 [95% CI 1.38-2.05], and PR 1.35 [95% CI 1.05-1.74], respectively). Furthermore, African Americans had increased prevalence of neurologic manifestations (PR 1.49 [95% CI 1.12-1.98]), and both African Americans (PR 1.09 [95% CI 1.04-1.15]) and Asian/Pacific Islanders (PR 1.07 [95% CI 1.01-1.13]) had increased prevalence of hematologic manifestations. African Americans, Asian/ Pacific Islanders, and Hispanic patients, respectively, had higher risk of developing lupus nephritis (HR 2.4 [95% CI 1.6-3.8], HR 4.3 [95% CI 2.9-6.4], and HR 2.3 [95% CI 1.4-3.8]) and thrombocytopenia (HR 2.3 [95% CI 1.1-4.4], HR 2.3 [95% CI 1.3-4.2], and HR 2.2 [95% CI 1.1-4.7]). Asian/Pacific Islander and Hispanic patients had higher risk of developing antiphospholipid syndrome (HR 2.5 [95% CI 1.4-4.4] and HR 2.6 [95% CI 1.3-5.1], respectively).Conclusion. This is the first epidemiologic study comparing lupus manifestations among 4 major racial and ethnic groups. We found substantial differences in the prevalence of several clinical SLE manifestations among racial/ethnic groups and discovered that African Americans, Asian/Pacific Islanders, and Hispanic patients are at increased risk of developing several severe manifestations following a diagnosis of SLE.

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Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Differences in the Prevalence and Time to Onset of Manifestations of Systemic Lupus Erythematosus: The California Lupus Surveillance Project

Maningding

Dall’Era

Trupin

et al. 2020

Arthritis Care & Research

100

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“…Several studies have found more organ damage in men, in particular renal insufficiency/failure. Our study has the largest number of men (except for the Veterans Administration study 20 , which did not systematically examine disease manifestations) and the largest prospective followup. In addition, the ethnic makeup of the Hopkins Lupus Cohort allowed us to look separately at white and African American male SLE.…”

Section: Discussionmentioning

confidence: 99%

“…An increased risk of renal failure in males was seen in 2 studies 7,14 . Male patients had more neurological involvement 3,7,9,17 , thrombotic events 9,14,15,17 , cardiovascular damage 14,16,17 , serositis 6,8,11,18 , arthritis 19 , hepatomegaly 19 , low C3 12 , thrombocytopenia 13 , later disease onset 3,20 , fever 12 , infection 17,21 , weight loss 12 , and hypertension 12 in some, but not all, series. In terms of serology, anticardiolipin antibodies 9,12,14 , anti-dsDNA 15 , and lupus anticoagulant (LAC) 10 were more prevalent in men in a few studies (summarized in Table 1).…”

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confidence: 99%

Differences between Male and Female Systemic Lupus Erythematosus in a Multiethnic Population

Tan¹,

Fang²,

Magder³

et al. 2012

J Rheumatol

155

133

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Objective Male patients with systemic lupus erythematosus (SLE) are thought to be similar to female patients with SLE, but key clinical characteristics may differ. Comparisons were made between male and female patients with SLE in the Hopkins Lupus Cohort. Methods A total of 1979 patients in the Hopkins Lupus Cohort were included in the analysis. Results The cohort consisted of 157 men (66.2% white, 33.8% African American) and 1822 women (59.8% white, 40.2% African American). The mean followup was 6.02 years (range 0–23.73). Men were more likely than women to have disability, hypertension, thrombosis, and renal, hematological, and serological manifestations. Men were more likely to be diagnosed at an older age and to have a lower education level. Women were more likely to have malar rash, photosensitivity, oral ulcers, alopecia, Raynaud’s phenomenon, or arthralgia. Men were more likely than women to have experienced end organ damage including neuropsychiatric, renal, cardiovascular, peripheral vascular disease, and myocardial infarction, and to have died. In general, differences between males and females were more numerous and striking in whites, especially with respect to lupus nephritis, abnormal serologies, and thrombosis. Conclusion Our study suggests that there are major clinical differences between male and female patients with SLE. Differences between male and female patients also depend on ethnicity. Future SLE studies will need to consider both ethnicity and gender to understand these differences.

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“…The crude survival was higher in the SLE group despite several features classically associated with worse outcomes, such as major incidence of chronic renal failure (32), higher LOS in the hospital and higher incidence of shock at admission to the ICU (33). However, SLE patients were predominantly young women, a factor strongly associated with better outcome (29,34). Ultimately, the balance of these characteristics resulted in a similar survival rate.…”

Section: Discussionmentioning

confidence: 99%

Outcomes and organ dysfunctions of critically ill patients with systemic lupus erythematosus and other systemic rheumatic diseases

Ranzani

Battaini

Moraes

et al. 2011

Braz J Med Biol Res

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2) at admission was higher in the other-SRD group, whereas severe hematological dysfunction (hematological SOFA >2) during ICU stay was higher in the SLE group. SLE patients were younger and displayed a decreased incidence of respiratory failure compared to patients with other-SRDs. However, the incidences of renal and hematological failure and the presence of shock at admission were higher in the SLE group. The 60-day survival rates were similar.]]>

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Systemic Lupus Erythematosus in Men: A Retrospective Analysis in a Veterans Administration Healthcare System Population

Cited by 26 publications

References 42 publications

Racial and Ethnic Differences in the Prevalence and Time to Onset of Manifestations of Systemic Lupus Erythematosus: The California Lupus Surveillance Project

Racial and Ethnic Differences in the Prevalence and Time to Onset of Manifestations of Systemic Lupus Erythematosus: The California Lupus Surveillance Project

Differences between Male and Female Systemic Lupus Erythematosus in a Multiethnic Population

Outcomes and organ dysfunctions of critically ill patients with systemic lupus erythematosus and other systemic rheumatic diseases

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