Longitudinal disease- and steroid-related damage among adults with childhood-onset systemic lupus erythematosus.
Semin Arthritis Rheum
; 49(2): 267-272, 2019 10.
Article
in En
| MEDLINE
| ID: mdl-31235075
ABSTRACT
OBJECTIVES:
Determine whether adults with childhood-onset systemic lupus erythematosus (cSLE) are at increased risk for disease- and steroid-related damage as compared to individuals with adult-onset SLE (aSLE), and whether they continue to accumulate disease damage in adulthood.METHODS:
Data derive from the 2007-2015 cycles of the Lupus Outcomes Study, a longitudinal cohort of adults with confirmed SLE. The Brief Index of Lupus Damage (BILD), a validated, patient-reported measure, was used to assess SLE-associated damage. Participants with baseline BILD were included (Nâ¯=â¯1035). Diagnosis at age < 18 years was defined as cSLE (Nâ¯=â¯113). Outcome variables included BILD score at baseline and follow-up, clinically significant change in BILD score over follow-up period, and presence of steroid-related damage (cataracts, osteoporosis-related fracture, avascular necrosis or diabetes mellitus).RESULTS:
Mean time between baseline and follow up BILD assessment was 6.3⯱â¯1.7 years. In adjusted analyses, participants with cSLE and aSLE had similar levels of disease-related damage, and accumulated damage at similar rates. Participants with cSLE were more likely to report steroid-related damage (OR 1.7, 95% CI 1.1-2.8) in the adjusted analysis as compared to those with aSLE. Likelihood of steroid-related damage increased with disease duration for both groups, but was consistently higher among cSLE participants.CONCLUSION:
In this longitudinal cohort of adults with SLE, participants continued to accumulate damage at similar rates over time, regardless of age at onset or disease duration. Childhood-onset predicted increased risk of steroid-related damage. Aggressive use of steroid-sparing treatment strategies during childhood may be important to prevent steroid-related damage in adulthood.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Glucocorticoids
/
Immunosuppressive Agents
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Lupus Erythematosus, Systemic
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
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Child
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Child, preschool
/
Female
/
Humans
/
Male
Language:
En
Journal:
Semin Arthritis Rheum
Year:
2019
Document type:
Article