Systemic lupus erythematosus in three ethnic groups. XX. Damage as a predictor of further damage.
OBJECTIVE
To examine the predictors of damage in a multiethnic cohort of systemic lupus erythematosus (SLE) patients with a specific focus on damage at baseline.


METHODS
SLE patients from a multiethnic US (Hispanic, African-American and Caucasian) cohort (LUMINA: Lupus in Minority populations, Nature versus nurture) were included if they had > or =6 months of follow-up in the cohort. Damage was measured with the Systemic Lupus International Collaborating Clinics (SLICC) Damage Index (SDI). The dependent variable was the change in SDI score between study visits. Predictors were from the preceding visit. Variables known to affect damage accrual in SLE were included in the analyses.


RESULTS
Three hundred and fifty-two patients (82 Hispanics, 153 African-Americans and 117 Caucasians) representing 1795 patient visits were included. Previous damage was found to be a significant predictor of subsequent damage accrual (P < 0.0001). Other variables predictive of subsequent damage accrual were disease activity (P < 0.0001), older age (P = 0.041) and use of corticosteroids (P = 0.0048).


CONCLUSIONS
Once damage occurs in SLE, further damage is expected to occur. This is more likely to be the case if disease activity persists. These data have clinical implications for the management of SLE patients.
Alarcón
G S
GS
Department of Medicine, Division of Clinical Immunology and Rheumatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA. graciela.alarcon@cc.uab.edu
Roseman
J M
JM
McGwin
G
G
Uribe
A
A
Bastian
H M
HM
Fessler
B J
BJ
Baethge
B A
BA
Friedman
A W
AW
Reveille
J D
JD
D000328:Adult; D001741:Black or African American; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000208:ethnology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D014481:United States; D044465:White People