title: Systemic lupus erythematosus: clinical features in patients with a disease duration of over 10 years, first evaluation.
abstract: OBJECTIVE
  Most information available about the disease course of patients with systemic lupus erythematosus (SLE) is restricted to the first 5 yr after disease onset. Data about the disease course 10 yr after disease onset are rare. The aim of this multicentre study was to describe the outcome of SLE patients with a disease duration of >10 yr.
  
  
  METHODS
  Outcome parameters were the SLE Disease Activity Index (SLEDAI), the European Consensus Lupus Activity Measure (ECLAM), the Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index (SLICC/ACR), a global damage index (DI) and required treatment. In 10 different European rheumatology centres, all SLE patients who were evaluated in the last 3 months of 1994, and who had been diagnosed with SLE at least 10 yr ago, were included in the study.
  
  
  RESULTS
  It should be stressed that our results are confined to a patient cohort, defined by a disease duration of at least 10 yr, and who are still under clinical care at the different centres in Europe. These SLE patients still showed some disease activity, related to symptoms of the skin and musculoskeletal systems, next to the presence of renal involvement. A total of 72% of the patients needed treatment with prednisolone (</=7.5 mg). The cumulative damage was overall related to clinical features of the central nervous system (14%) and renal involvement (14%), next to deforming arthritis (14%), osteoporosis (15%) and hypertension (40%). The prevalences of obesity, Cushing appearance and diabetes are highly suggestive that the ongoing treatment and that in the past might have had an impact on the total sum of end-organ damage.
  
  
  CONCLUSIONS
  After 10 yr, a high proportion of patients in our cohort continued to show evidence of active disease, defined by the SLEDAI as well as ECLAM. The DI was related to the involvement of the central nervous system, renal involvement and the presence of hypertension.
authors.affiliation: Department of Rheumatology, Zuiderzeikenhuis, Groene Hilledijk, Rotterdam, The Netherlands.
authors.forename: A J
authors.initials: AJ
authors.lastname: Swaak
authors.forename: H G
authors.initials: HG
authors.lastname: van den Brink
authors.forename: R J
authors.initials: RJ
authors.lastname: Smeenk
authors.forename: K
authors.initials: K
authors.lastname: Manger
authors.forename: J R
authors.initials: JR
authors.lastname: Kalden
authors.forename: S
authors.initials: S
authors.lastname: Tosi
authors.forename: A
authors.initials: A
authors.lastname: Marchesoni
authors.forename: Z
authors.initials: Z
authors.lastname: Domljan
authors.forename: B
authors.initials: B
authors.lastname: Rozman
authors.forename: D
authors.initials: D
authors.lastname: Logar
authors.forename: G
authors.initials: G
authors.lastname: Pokorny
authors.forename: L
authors.initials: L
authors.lastname: Kovacs
authors.forename: A
authors.initials: A
authors.lastname: Kovacs
authors.forename: P G
authors.initials: PG
authors.lastname: Vlachoyiannopoulos
authors.forename: H M
authors.initials: HM
authors.lastname: Moutsopoulos
authors.forename: H
authors.initials: H
authors.lastname: Chwalinska-Sadowska
authors.forename: B
authors.initials: B
authors.lastname: Dratwianka
authors.forename: E
authors.initials: E
authors.lastname: Kiss
authors.forename: N
authors.initials: N
authors.lastname: Cikes
authors.forename: A
authors.initials: A
authors.lastname: Branimir
authors.forename: M
authors.initials: M
authors.lastname: Schneider
authors.forename: R
authors.initials: R
authors.lastname: Fischer
authors.forename: S
authors.initials: S
authors.lastname: Bombardieri
authors.forename: M
authors.initials: M
authors.lastname: Mosca
authors.forename: J S
authors.initials: JS
authors.lastname: Smolen
mesh_terms: D000328:Adult; D017668:Age of Onset; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D018501:Antirheumatic Agents / Q000008:administration & dosage; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013256:Steroids; D013997:Time Factors
chemical_list: D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D013256:Steroids