Predictors of organ damage identified in patients with SLE

Michelle Petri, M.D., M.P.H., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues used data from 2,054 patients with SLE in the Hopkins Lupus Cohort in an effort to identify predictors of organ damage, as assessed by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (ACR) Damage Index (SDI).

The researchers found that the rate of increase of the SDI score was 0.13 per year. African-American, male, or older patients as well as those with lower income or educational levels had higher rates of damage. Additionally, SLE patients with hypertension, proteinuria, or who were positive for lupus anticoagulant had increased rates of organ damage. During follow-up, those who were older, received corticosteroids, had more disease activity, satisfied more ACR criteria for SLE, had low complement levels, or who were positive for anti-double-stranded DNA had a higher risk of organ damage. Of these factors, age, hypertension, and corticosteroid use were the most important predictors of cumulative organ damage in SLE patients. Lower risk was seen for patients receiving hydroxychloroquine.

"Our findings indicate that rates of damage vary in demographic subgroups, but much variation appears to be explained by hypertension and corticosteroid use," the authors write. "These data clearly point to the need for tight control of disease activity without reliance on corticosteroids."

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Journal reference: Arthritis & Rheumatism

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