Because Drs. Katz and Yelin are Editors of Arthritis Care & Research, review of this article was handled by the Editor of Arthritis & Rheumatism.
Systemic Lupus Erythematosus
Differences in long-term disease activity and treatment of adult patients with childhood- and adult-onset systemic lupus erythematosus
Article first published online: 30 DEC 2008
Copyright © 2008 by the American College of Rheumatology
Arthritis Care & Research
Volume 61, Issue 1, pages 13–20, 15 January 2009
How to Cite
Hersh, A. O., von Scheven, E., Yazdany, J., Panopalis, P., Trupin, L., Julian, L., Katz, P., Criswell, L. A. and Yelin, E. (2009), Differences in long-term disease activity and treatment of adult patients with childhood- and adult-onset systemic lupus erythematosus. Arthritis & Rheumatism, 61: 13–20. doi: 10.1002/art.24091
- Issue published online: 30 DEC 2008
- Article first published online: 30 DEC 2008
- Manuscript Accepted: 9 SEP 2008
- Manuscript Received: 18 MAR 2008
- National Center for Research Resources of the US Public Health Service. Grant Number: 5-M01-RR-00079
- NIH. Grant Number: T32-AR-0734
- American College of Rheumatology Physician Scientist Development award
- NIH through the Rosalind Russell Medical Research Center for Arthritis. Grant Numbers: K24-AR02175, R01-AR44804
- State of California Lupus Fund
- Arthritis Foundation
- Agency for Healthcare Research and Quality
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Numbers: 1-R01-HS013893, P60-AR053308
To compare differences in long-term outcome between adults with childhood-onset (age at diagnosis <18 years) systemic lupus erythematosus (SLE) and with adult-onset SLE.
Data were derived from the University of California Lupus Outcomes Study, a longitudinal cohort of 885 adult subjects with SLE (90 childhood-onset [cSLE], 795 adult-onset [aSLE]). Baseline and 1-year followup data were obtained via structured 1-hour telephone interviews conducted between 2002 and 2006. Using self-report data, differences in organ involvement and disease morbidity, current disease status and activity, past and current medication use, and number of physician visits were compared, based on age at diagnosis of SLE.
Average disease duration for the cSLE and aSLE subgroups was 16.5 and 13.4 years, respectively, and mean age at followup was 30.5 and 49.9 years, respectively. When compared with aSLE subjects, cSLE subjects had a higher frequency of SLE-related renal disease, whereas aSLE subjects were more likely to report a history of pulmonary disease. Rates of clotting disorders, seizures, and myocardial infarction were similar between the 2 groups. At followup, cSLE subjects had lower overall disease activity, but were more likely to be taking steroids and other immunosuppressive therapies. The total number of yearly physician visits was similar between the 2 groups, although cSLE subjects had a higher number of nephrology visits.
This study demonstrates important differences in the outcomes of patients with cSLE and aSLE, and provides important prognostic information about long-term SLE disease activity and treatment.