Dr. Fortin has received consultancy fees, speaking fees, and/or honoraria (less than $10,000 each) from Biogen Idec and GlaxoSmithKline, and has served on the MedImmune Advisory Board.
Systemic Lupus Erythematosus
Evolution of disease burden over five years in a multicenter inception systemic lupus erythematosus cohort
Article first published online: 28 DEC 2011
Copyright © 2012 by the American College of Rheumatology
Arthritis Care & Research
Volume 64, Issue 1, pages 132–137, January 2012
How to Cite
Urowitz, M. B., Gladman, D. D., Ibañez, D., Fortin, P. R., Bae, S. C., Gordon, C., Clarke, A., Bernatsky, S., Hanly, J. G., Isenberg, D., Rahman, A., Sanchez-Guerrero, J., Wallace, D. J., Ginzler, E., Alarcón, G. S., Merrill, J. T., Bruce, I. N., Sturfelt, G., Nived, O., Steinsson, K., Khamashta, M., Petri, M., Manzi, S., Ramsey-Goldman, R., Dooley, M. A., van Vollenhoven, R. F., Ramos, M., Stoll, T., Zoma, A., Kalunian, K. and Aranow, C. (2012), Evolution of disease burden over five years in a multicenter inception systemic lupus erythematosus cohort. Arthritis Care Res, 64: 132–137. doi: 10.1002/acr.20648
- Issue published online: 28 DEC 2011
- Article first published online: 28 DEC 2011
- Accepted manuscript online: 27 SEP 2011 10:31AM EST
- Manuscript Accepted: 13 SEP 2011
- Manuscript Received: 5 MAY 2011
- Canadian Institutes of Health Research
- Lupus Foundation of Ontario
- Lupus UK
- Lupus Ontario
- Conn Smythe Foundation
- Tolfo Family
- Lupus Foundation of America State Chapters of New Jersey
- Long Island-Queens, Western New York, and Nashville
We describe disease activity, damage, and the accrual of key autoantibodies in an inception systemic lupus erythematosus (SLE) cohort.
The Systemic Lupus International Collaborating Clinics (SLICC) International Research Network, comprising 27 centers from 11 countries, has followed an inception cohort of SLE patients yearly according to a standardized protocol. Of these patients, 298 were followed for a minimum of 5 years and constitute the study population. Disease activity was assessed using the SLE Disease Activity Index 2000 (SLEDAI-2K) and damage was assessed using the SLICC/American College of Rheumatology Damage Index (SDI). Antinuclear antibody (ANA), anti-DNA, and anticardiolipin antibody (aCL) levels and lupus anticoagulant were assessed yearly. Descriptive statistics were generated and repeated-measures general linear models were used to evaluate SLEDAI-2K and SDI over time between whites and nonwhites.
Of the 298 patients, 87% were women, 55% were white, 12% were African American, 14% were Asian, 16% were Hispanic, and 2% were categorized as “other.” At enrollment, the mean age was 35.3 years, the mean SLEDAI-2K score was 5.9, and the mean disease duration was 5.5 months. Mean SLEDAI-2K scores decreased in the first year and then remained low. SLEDAI-2K scores were significantly lower at each year in whites compared to nonwhites. Mean SDI scores increased progressively over 5 years; there was no significant difference between whites and nonwhites. As expected, ANA positivity was high and anti-DNA positivity was relatively low at enrollment, and both increased over 5 years. Although lupus anticoagulant increased slightly over 5 years, aCL positivity did not.
Disease activity in newly diagnosed patients decreases over their first 5 years, while damage increases. Antibody positivity ran variable courses over this period.