title: Factors associated with disease expression patterns in systemic lupus erythematosus patients: results from LUMINA (LXXVII), a multiethnic US cohort.
abstract: Objective The objective of this study was to determine the association of disease expression patterns with demographic and clinical characteristics in SLE. Methods Patients from a multi-ethnic SLE cohort were included. Disease expression patterns were defined as acute SLE and insidious SLE; this group was divided into those who accrued three ACR criteria and then accrued the fourth (insidious pattern A) and those who have one or two and then accrued four criteria (insidious pattern B). Disease activity was ascertained with the SLAM-R and disease damage with SLICC/ACR damage index. Variables were compared using analysis of variance for numeric variables and χ2for categorical variables. Multivariable analyses adjusting for possible confounders were performed. Results Six hundred and forty patients were included; the most frequent pattern was the insidious pattern B, with 415 (64.8%) patients, followed by the acute SLE group with 115 (18.0%) and the insidious pattern A with 110 (17.2%) patients. Patients from the insidious pattern A were older at diagnosis (pattern A: 39.8 vs pattern B: 36.7 vs acute: 32.4 years; p < 0.0001), more educated (13.6 vs 13.1 vs 12.1; p = 0.0008) and with a less active disease at baseline (8.8 vs 9.2 vs 10.7; p = 0.0227). Caucasian and Hispanic (Puerto Rico) ethnicities were overrepresented in this group (40.0% vs 27.7% vs 19.1% and 18.2% vs 17.1% vs 9.6%; p = 0.0003). Conclusions More insidious onset is associated with older age, Caucasian ethnicity, higher level of education, and lower disease activity than those with acute onset. However, after multivariable analyses, disease activity was not associated with any disease expression pattern.
authors: 1 Servicio de Reumatología, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Perú.|2 Universidad Científica del Sur, Lima, Perú.
authors: M F
authors: MF
authors: Ugarte-Gil
authors: 1 Servicio de Reumatología, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Perú.
authors: V R
authors: VR
authors: Pimentel-Quiroz
authors: 3 Department of Internal Medicine, Division of Rheumatology, University of Puerto Rico, San Juan, Puerto Rico.
authors: L M
authors: LM
authors: Vilá
authors: 4 Department of Medicine, Division of Rheumatology, The University of Texas-Health Science Center at Houston, Houston, USA.
authors: J D
authors: JD
authors: Reveille
authors: 5 Department of Epidemiology, Schools of Medicine and Public Health, The University of Alabama at Birmingham, Birmingham, USA.
authors: G
authors: G
authors: McGwin
authors: 6 Department of Medicine, Division of Clinical Immunology and Rheumatology, School of Medicine, The University of Alabama at Birmingham, Birmingham, USA.
authors: G S
authors: GS
authors: Alarcón
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000145:classification* / Q000453:epidemiology* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D014481:United States / Q000208:ethnology; D055815:Young Adult
keywords: Systemic lupus erythematosus; disease patterns; ethnicity; prognosis