title: Factors predictive of high disease activity early in the course of SLE in patients from a Latin-American cohort.
abstract: To determine the factors predictive of disease activity early in the course of SLE (baseline visit).
  
  
  
  Patients from GLADEL, a multi-national, multi-ethnic, Latin-American lupus cohort were included. Disease activity was evaluated at baseline with the SLEDAI score. Demographic characteristics (age at diagnosis, gender, ethnicity, marital status, educational level, medical coverage and socioeconomic status) were assessed. Disease duration was defined as the time between the fourth ACR criterion and baseline. Time to criteria accrual was defined as the interval between the first and fourth ACR criterion. Use of glucocorticoids was recorded as the highest dose received before the baseline visit. Antimalarials and immunosuppressive drugs were recorded as use or not use. Univariable and multivariable analysis were performed. Model selection was based on backward elimination.
  
  
  
  One thousand two hundred sixty-eight patients were included; 1136 (89.6%) of them were female. Mean age at diagnosis was 29.2 (SD: 12.3) years. Five hundred sixty-five (44.6%) were Mestizo, 539 (42.5%) were Caucasians and 164 (12.9%) were African-Latin-Americans. The mean SLEDAI at baseline was 10.9 (SD: 8.4). Longer time between first and fourth ACR criterion, medical coverage, a dose of prednisone between 15 and 60mg/d, and the use of antimalarials were factors protective of disease activity, while Mestizo and African-Latin-American ethnicities were predictive factors.
  
  
  
  Mestizo and African-Latin-American ethnicities were predictive whereas antimalarial use, medical coverage, and longer time to criteria accrual were protective of higher disease activity early in the disease course.
authors.affiliation: Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Av. Grau 800, La Victoria, Lima 13, Lima, Peru. Electronic address: victorpq4@gmail.com.
authors.forename: Victor R
authors.initials: VR
authors.lastname: Pimentel-Quiroz
authors.affiliation: Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Av. Grau 800, La Victoria, Lima 13, Lima, Peru; Universidad Científica del Sur, Lima, Peru.
authors.forename: Manuel F
authors.initials: MF
authors.lastname: Ugarte-Gil
authors.affiliation: Department of Autoimmune Diseases, Institut Clínic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Spain.
authors.forename: Guillermo J
authors.initials: GJ
authors.lastname: Pons-Estel
authors.affiliation: Sección de Reumatología, Servicio de Clínica Médica, Hospital Italiano and Fundación Dr. Pedro M. Catoggio para el Progreso de la Reumatología, Buenos Aires, Argentina.
authors.forename: Enrique R
authors.initials: ER
authors.lastname: Soriano
authors.affiliation: Servicio de Reumatología, Hospital Privado, Centro Medico de Córdoba, Córdoba, Argentina.
authors.forename: Verónica
authors.initials: V
authors.lastname: Saurit
authors.affiliation: Departamento de Medicina, Disciplina de Reumatología, Escola Paulista de Medicina, Universidade Federal da São Paulo-UNIFESP, São Paulo, Brazil.
authors.forename: Emilia I
authors.initials: EI
authors.lastname: Sato
authors.affiliation: Disciplina de Reumatología, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas-UNICAMP, Campinas, Brazil.
authors.forename: Lilian T
authors.initials: LT
authors.lastname: Lavras Costallat
authors.affiliation: Reumalab, Centro Integral de Reumatología, Medellín, Colombia.
authors.forename: José Fernando
authors.initials: JF
authors.lastname: Molina
authors.affiliation: Departamento de Medicina, Universidad del Bosque, Bogotá, Colombia.
authors.forename: Antonio
authors.initials: A
authors.lastname: Iglesias-Gamarra
authors.affiliation: Servicio de Reumatología, Centro de Investigaciones Médico Quirúrgicas-CIMEQ, Havana, Cuba.
authors.forename: Gil
authors.initials: G
authors.lastname: Reyes-Llerena
authors.affiliation: Servicio de Reumatología, Hospital del Salvador, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
authors.forename: Oscar J
authors.initials: OJ
authors.lastname: Neira
authors.affiliation: Servicio de Reumatología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico.
authors.forename: Leonor A
authors.initials: LA
authors.lastname: Barile
authors.affiliation: Departamento de Reumatología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de Mexico, Mexico.
authors.forename: Luis H
authors.initials: LH
authors.lastname: Silveira
authors.affiliation: Servicio de Reumatología, Hospital Nacional Edgardo Rebagliatti Martins, Essalud, Lima, Peru.
authors.forename: María Ines
authors.initials: MI
authors.lastname: Segami
authors.affiliation: Servicio de Reumatología, Centro Nacional de Enfermedades Reumáticas, Hospital Universitario de Caracas, Caracas, Venezuela.
authors.forename: Rosa
authors.initials: R
authors.lastname: Chacón-Díaz
authors.affiliation: Department of Statistic, Associated to GLADEL, Rosario, Argentina.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wojdyla
authors.affiliation: Department of Medicine, Division of Clinical Immunology and Rheumatology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Graciela S
authors.initials: GS
authors.lastname: Alarcón
authors.affiliation: Servicio de Reumatología, Hospital Provincial de Rosario, Rosario, Argentina.
authors.forename: Bernardo A
authors.initials: BA
authors.lastname: Pons-Estel
mesh_terms: D000293:Adolescent; D000328:Adult; D018450:Disease Progression; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007843:Latin America; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D005938:Glucocorticoids
keywords: Antimalarial use; Disease activity; Ethnic group; Systemic lupus erythematosus