title: SLICC/ACR Damage Index in Afro-Caribbean patients with systemic lupus erythematosus: changes in and relationship to disease activity, corticosteroid therapy, and prognosis.
abstract: OBJECTIVE
  To apply the recently described Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI) in a well defined cohort of patients with systemic lupus erythematosus (SLE) and to study its association with disease activity, corticosteroid therapy, and prognosis.
  
  
  METHODS
  We conducted a record review of 90 patients with SLE followed at a single center for a mean period of 6 years with periodic evaluations of SLE Disease Activity Index (SLEDAI), cumulative damage according to SLICC/ACR-DI, and therapy. Overall disease activity during the disease course was calculated as weighted averages of SLEDAI (WAS).
  
  
  RESULTS
  Mean SLICC/ACR-DI was 0.6 six months after diagnosis and increased to 2.4 at last assessment. Thirteen patients (14%) remained free of accumulated damage at last visit. Index scores showed significant correlations with WAS scores and the number of disease exacerbations (SLEDAI > 10), but not with age, mean daily, or cumulative corticosteroid dosage. High WAS scores were independently associated with poorer survival, but SLICC/ACR-DI scores were not.
  
  
  CONCLUSIONS
  SLICC/ACR-DI scores correlate with overall disease activity, but not with length or intensity of corticosteroid therapy. While easily applicable, its prognostic value is subordinate to that of persistent disease activity.
authors.affiliation: Department of Medicine, St. Elisabeth Hospital, Willemstad, Curaçao, Netherlands Antilles.
authors.forename: J C
authors.initials: JC
authors.lastname: Nossent
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000349:Africa / Q000208:ethnology; D017691:Caribbean Region; D006305:Health Status Indicators; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D008875:Middle Aged; D011379:Prognosis
chemical_list: D000305:Adrenal Cortex Hormones